To amend sections 3709.09, 3730.01 to 3730.09, 3730.11, and 3730.99; to amend, for the purpose of adopting new section numbers as indicated in parentheses, sections 3730.01 (4785.01), 3730.02 (4785.02), 3730.03 (4785.05), 3730.04 (4785.06), 3730.05 (4785.07), 3730.06 (4785.08), 3730.07 (4785.09), 3730.08 (4785.10), 3730.09 (4785.11), 3730.11 (4785.18), and 3730.99 (4785.99); to enact sections 4785.03, 4785.04, 4785.051, 4785.12, and 4785.14 to 4785.17; and to repeal section 3730.10 of the Revised Code to create the State Board of Body Modification, to require licensure of tattoo and body piercing artists, and to make other changes to the tattooing and piercing laws.

Section 1. That sections 3709.09, 3730.01, 3730.02, 3730.03, 3730.04, 3730.05, 3730.06, 3730.07, 3730.08, 3730.09, 3730.11, and 3730.99 be amended; sections 3730.01 (4785.01), 3730.02 (4785.02), 3730.03 (4785.05), 3730.04 (4785.06), 3730.05 (4785.07), 3730.06 (4785.08), 3730.07 (4785.09), 3730.08 (4785.10), 3730.09 (4785.11), 3730.11 (4785.18), and 3730.99 (4785.99) be amended for the purpose of adopting new section numbers as indicated in parentheses; and sections 4785.03, 4785.04, 4785.051, 4785.12, 4785.14, 4785.15, 4785.16, and 4785.17 of the Revised Code be enacted to read as follows:

Sec. 3709.09.  (A) The board of health of a city or general health district may, by rule, establish a uniform system of fees to pay the costs of any services provided by the board.

The fee for issuance of a certified copy of a vital record or a certification of birth shall not be less than the fee prescribed for the same service under division (A)(1) of section 3705.24 of the Revised Code and shall include the fees required by division (B) of section 3705.24 and section 3109.14 of the Revised Code.

Fees for services provided by the board for purposes specified in sections 3701.344, 3711.10, 3718.06, 3729.07, 3730.03, and 3749.04 of the Revised Code shall be established in accordance with rules adopted under division (B) of this section. The district advisory council, in the case of a general health district, and the legislative authority of the city, in the case of a city health district, may disapprove any fee established by the board of health under this division, and any such fee, as disapproved, shall not be charged by the board of health.

(B) The director of health shall adopt rules under section 111.15 of the Revised Code that establish fee categories and a uniform methodology for use in calculating the costs of services provided for purposes specified in sections 3701.344, 3711.10, 3718.06, 3729.07, 3730.03, and 3749.04 of the Revised Code. In adopting the rules, the director shall consider recommendations it receives from advisory boards established either by statute or the director for entities subject to the fees.

(C) Except when a board of health establishes a fee by adopting a rule as an emergency measure, the board of health shall hold a public hearing regarding each proposed fee for a service provided by the board for a purpose specified in section 3701.344, 3711.10, 3718.06, 3729.07, 3730.03, or 3749.04 of the Revised Code. If a public hearing is held, at least twenty days prior to the public hearing the board shall give written notice of the hearing to each entity affected by the proposed fee. The notice shall be mailed to the last known address of each entity and shall specify the date, time, and place of the hearing and the amount of the proposed fee.

(D) If payment of a fee established under this section is not received by the day on which payment is due, the board of health shall assess a penalty. The amount of the penalty shall be equal to twenty-five per cent of the applicable fee.

(E) All rules adopted by a board of health under this section shall be adopted, recorded, and certified as are ordinances of municipal corporations and the record thereof shall be given in all courts the same effect as is given such ordinances, but the advertisements of such rules shall be by publication in one newspaper of general circulation within the health district. Publication shall be made once a week for two consecutive weeks or as provided in section 7.16 of the Revised Code, and such rules shall take effect and be in force ten days from the date of the first publication.

Sec. 3730.01 4785.01.  As used in this chapter:

(A) "Aftercare" means verbal and written guidelines, specific to a body modification procedure performed, about caring for the body modification and the surrounding area, including information about physical restrictions, wound care, signs and symptoms of infection, and when to seek medical treatment, if necessary.

"Antiseptic solution" means an agent that arrests or prevents the growth of microorganisms.

"Approval" means written approval from the local board of health pursuant to section 4785.05 of the Revised Code indicating that the body modification establishment has been inspected and meets all requirements established by this chapter, the rules adopted under it, and the local board of health.

"Aseptic technique" means a set of specific practices and procedures performed under controlled conditions with the goal of minimizing contamination by pathogens.

"Board of health" means the board of health of a city or general health district or the authority having the duties of a board of health under section 3709.05 of the Revised Code.

(B) "Body modification" means an aesthetic, nonmedical body alteration, including tattooing, permanent cosmetics, or body piercing. "Body modification" does not include any practice that would require a license under Chapter 4709., 4713., 4715., 4717., 4723., 4730., or 4731. of the Revised Code.

"Body modification practitioner" means an individual, including an operator, who performs one or more of the following procedures:

Tattooing;

Permanent cosmetics;

Body piercing;

Scarification;

Branding.

"Body modification establishment" means any place, whether temporary or permanent, stationary or mobile, where body modification is performed.

"Body piercing" means the puncturing of any part of the body by a person who utilizes a needle or other industry specific instrument for the purpose of inserting an object into the body for nonmedical purposes.

"Body piercing" includes ear piercing, except when the ear piercing procedure is performed with an ear piercing gun, and includes surface anchors and surface piercing. "Body piercing" does not include any practice that would require a license under Chapter 4715., 4717., 4723., 4730., or 4731. of the Revised Code.

(C) "Business" means any entity that provides body modification services for compensation.

(D) "CPR" has the same meaning as in section 2133.21 of the Revised Code.

"Custodian" has the same meaning as in section 2151.011 of the Revised Code.

(E) "Disinfectant" means a product, registered by the United States environmental protection agency, that kills or destroys nearly all disease-producing microorganisms, with the exception of bacterial spores.

"Ear piercing gun" means a mechanical device that pierces the ear by forcing a disposable single-use stud or solid needle through the ear.

(F) "Glove" mean a medical-grade, disposable, single-use covering for a hand worn for protection against disease transmission.

"Guardian" has the same meaning as in section 2111.01 of the Revised Code.

"Hand washing" means the process of physically removing or reducing most microorganisms from the hands by thoroughly washing all surfaces of the hands and under fingernails with soap and warm running water for twenty seconds, rinsing hands well under running water, and drying hands thoroughly with a clean single-use towel or mechanical hand dryer.

"Infectious waste" means waste as defined in section 3734.01 of the Revised Code.

"Local board of health" means the board of health in which the business is located.

"Operator" means any person, firm, company, corporation, or association that owns, controls, operates, conducts, or manages a body modification establishment. The operator may or may not be a body modification practitioner.

"Patron" means a person requesting and receiving body modification services or ear piercing services performed with an ear piercing gun.

"Permanent cosmetics" means a tattoo, performed by someone other than a physician licensed under Chapter 4731. of the Revised Code, placed on the eyebrows, eyelids, lips, and other parts of the body for beauty marks, hair imitation, lash enhancement, or areola repigmentation. This term includes any procedure referred to as "permanent makeup," "microdermapigmentation," "micropigment implantation," or "dermagraphics." For the purposes of this chapter, "permanent cosmetics" has the same meaning as "tattoo." "Permanent cosmetics" does not include any practice that is considered a medical procedure by the state medical board.

"Premises" means the physical location of a body modification establishment.

"Single use" means products or items that are intended for one-time, one-person use and are disposed of after use on any patron.

"Sterilization" means a process by which all forms of microbial life, including bacteria, viruses, spores, and fungi, are destroyed.

"Standard precautions" means a set of minimum infection prevention guidelines and controls, published by the United States centers for disease control and prevention that include the following:

Hand hygiene;

Use of protective equipment;

Safe needle practices;

Safe handling of potentially contaminated equipment or surfaces;

Respiratory hygiene and cough etiquette.

"Surface anchor" means jewelry that is placed into the upper portion of the dermis that has one point of entry, which also serves as the exit that exposes the jewelry stem to air.

"Surface piercing" means any piercing on the surface of the body, under the epidermis but not to subcutaneous tissue, for which the piercing canal is under the surface of the skin with exit and entry points perpendicular to the tissue.

"Tattoo" means any method utilizing needles or other industry specific instruments by someone other than a physician licensed under Chapter 4731. of the Revised Code to permanently place designs, letters, scrolls, figures, symbols, or any other marks upon or under the skin of a person with ink, dye, pigment, or any other substance resulting in an alteration of the appearance of the skin. "Tattoo" does not include any practice that would require a license under Chapter 4715., 4717., 4723., 4730., or 4731. of the Revised Code.

Sec. 3730.02 4785.02.  No person shall do any of the following:

(A) Perform or engage in a body modification procedure unless the person holds a current, valid license issued by the state board of body modification under this chapter to engage in that activity;

(B) Perform or engage in a body modification procedure unless the person engages in that procedure in a place of business approved by a local board of health pursuant to this chapter;

(C) Operate a business that offers tattooing or body piercing modification services unless a local board of health has approved the business under section 3730.03 4785.05 of the Revised Code;

(B)(D) Perform a tattooing or body piercing modification procedure in a manner that does not meet the safety and sanitation standards established by this chapter and the rules adopted under section 3730.10 of the Revised Code pursuant to it;

(C)(E) Perform a tattooing procedure, body piercing modification procedure, or ear piercing procedure with an ear piercing gun in a manner that does not meet the standards for appropriate disinfection and sterilization of invasive equipment or parts of equipment used in performing the procedures established by this chapter and the rules adopted under section 3730.10 of the Revised Code pursuant to it;

(F) Perform an ear piercing with an ear piercing gun in a manner that does not meet the requirements prescribed in section 4785.17 of the Revised Code;

(G) Construct, install, provide, equip, or extensively alter a body modification establishment until all plans and specifications, as described in accordance with section 4785.05 of the Revised Code, for the facility layout, equipment, and operation have been submitted to and accepted, in writing, by the local board of health;

(H) While acting as an operator of an approved business performing body modification services, permit services to be performed by an employee of the business outside the business premises, unless those services are performed for an approved time-limited operation, as described in section 4785.051 of the Revised Code.

Sec. 4785.03. (A) There is hereby created the state board of body modification, consisting of nine members. The director of health shall appoint six members of the board. The governor shall appoint three members of the board. Requirements for membership and terms of office shall be determined by the director, except that three members of the board shall be body modification practitioners, licensed under this chapter. Initial terms of the board members shall be staggered as determined by the director of health. Members shall not receive compensation. Three-fifths of the board shall constitute a quorum for the transaction of business.

(B) The board shall hold a meeting to transact its business at least twice a year. The board may hold additional meetings at the discretion of the director of health. The board shall meet at times and places determined by the director of health.

(C) The board shall issue licenses to individuals who wish to engage in body modification procedures who satisfy the licensing requirements adopted pursuant to section 4785.04 of the Revised Code.

(D) The board shall regulate and inspect operators providing ear piercing services with an ear piercing gun.

Sec. 4785.04.  The state board of body modification shall adopt rules in accordance with Chapter 119. of the Revised Code to do all of the following:

(A)(1) Establish licensing and renewal standards and requirements;

(2) These rules shall address, at minimum, all of the following:

(a) Appropriate training in body modification services in all of the following:

(i) Sterilization;

(ii) Aftercare;

(iii) Prevention of transmission of blood-borne and other infectious diseases;

(iv) CPR;

(v) First aid.

(b) Entities that are recognized to provide such training and instruction;

(c) Experience in addition to or in lieu of training;

(d) Providing evidence of training and experience.

(B) Establish any safety, sanitation, disinfection, and sterilization standards and procedures that, in addition to other requirements of this chapter, are necessary for the safe performance of body modification procedures;

(C) Establish any other procedures necessary for the implementation and enforcement of this chapter;

(D) Collect safety, sanitation, disinfection, and sterilization information about body modification establishments from local boards of health;

(E) Create a report based on the information collected pursuant to division (D) of this section regarding compliance with standards and procedures required by this chapter or any rules adopted pursuant to it. The report shall be submitted annually to the majority and minority leaders of the senate and the house of representatives by the thirtieth of November each year;

(F) Adopt rules requiring body modification inspectors to undergo continuing education. The requirements shall include, at minimum, continuing education related to blood-borne pathogens;

(G) Any other rules necessary for the implementation of this chapter.

Sec. 3730.03 4785.05. (A) To receive approval to operate a business offering body modification services or acceptance of plans to construct, install, provide, equip, or extensively alter a body modification establishment, a business must demonstrate to the local board of health the ability to meet the requirements established by this chapter, the rules adopted under this chapter, and the local board of health for all of the following:

(1) The safe performance of body modification procedures;

(2) Training of individuals who perform the procedures;

(3) Maintenance of records;

(4) Compliance with body modification establishment standards.

(B) A person seeking approval to operate a business that offers tattooing or body piercing modification services shall apply at the time the person submits the plans and specifications pursuant to division (C) of this section, to the local board of health of the city or general health district in which the business is located on forms the board shall prescribe and provide. The applicant shall submit all applicable fees and information the board of health determines is necessary to process the application. The applicant shall include the fee established under section 3709.09 of the Revised Code with the application. The application form shall require all of the following:

(1) The name, address, telephone number, business address, business telephone number, and occupation of the operator. If the operator is an association, corporation, or partnership, the address and telephone number of the entity and the name of every person who has an ownership interest of five per cent or more in the association, corporation, or partnership.

(2) The name of each person or entity that has an ownership interest of five per cent or more in the business;

(3) A statement of attestation that the operator intends to comply with all requirements of this chapter and the rules of the board of health and the state board of body modification, if applicable;

(4) A list of each body modification practitioner who has received adequate training, as specified by the board of body modification in rule, and will be performing body modification services in the body modification establishment.

(C) A person seeking acceptance of plans to construct, install, provide, equip, or extensively alter a body modification establishment shall submit plans and specifications for approval to the local board of health. The plans and specifications shall include all of the following:

(1) The total area to be used for the business;

(2) Entrances and exits;

(3) The number, location, and types of plumbing fixtures, including all water supply facilities;

(4) A lighting plan;

(5) A floor plan, showing the general layout of the fixtures and equipment;

(6) A list of all sterilization or other equipment to be used, including the manufacturer and model numbers, as specified by the board in rules;

(7) Written verification from the zoning authority and building department with jurisdiction that the building has been zoned and approved for the business use;

(8) A written infection prevention and control plan that includes the following:

(a) The process for decontaminating and disinfecting environmental surfaces;

(b) The process for decontaminating, packaging, sterilizing, and storing reusable equipment and instruments;

(c) The process for protecting clean instruments and sterile instruments from contamination during storage;

(d) The process for ensuring that standard precautions and aseptic techniques are utilized during all body modification procedures;

(e) Guidelines for the safe handling and disposal of needles;

(f) Guidelines for aftercare guidelines;

(g) Guidelines for obtaining the consent of the guardian of a minor to perform a body modification procedure on that minor.

(D)(1) The approval and annual renewal fees for tattoo and body piercing businesses shall be one hundred fifty dollars for a permanent body modification business or the amount established in section 4785.051 of the Revised Code for a body modification business established on a time-limited basis.

(2) Boards of health shall deposit all fees collected under this section into the health fund of the district that the board serves. The fees shall be used solely for the purposes of implementing and enforcing this chapter.

To receive approval to offer tattooing or body piercing services, a business must demonstrate to a board of health the ability to meet the requirements established by this chapter and the rules adopted under section 3730.10 of the Revised Code for safe performance of the tattooing or body piercing procedures, training of the individuals who perform the procedures, and maintenance of records (3) Each fee shall be specified in accordance with the following categories:

(a) Tattooing services;

(b) Body piercing services;

(c) Combined body modification services;

(d) Time-limited approval for a specific event.

(4) No approval and inspection fees in addition to those fees described in division (D)(1) of this section shall be charged on, or with respect to, the operation and ownership of a body modification establishment within this state, except that the local board of health may charge additional reasonable fees for the collection and bacteriological examination of any necessary water samples taken from an establishment.

(E) A local board of health that determines, following an inspection conducted under section 3730.04 4785.06 of the Revised Code, that a business meets the requirements for approval shall approve the business. Approval remains valid for one year, unless earlier suspended or revoked under section 3730.05 4785.07 of the Revised Code. A business's approval may be renewed. Approval is not transferable.

(1) Initial approvals granted on or after October first shall be effective from the date of issuance until December thirty-first of the following year, unless suspended or revoked pursuant to section 4785.07 of the Revised Code.

(2) Every person who intends to renew an approval to operate or maintain a body modification establishment shall apply to the local board of health on or after November first of each year. Applications received or postmarked after December thirty-first shall be assessed a penalty. The amount of the penalty shall be equal to twenty-five per cent of the applicable fee. Applications received between November first and December thirty-first that are subsequently approved shall be valid until the thirty-first day of December next. Applications received after December thirty-first and subsequently approved shall be valid until the thirty-first day of December of the calendar year.

(3) An operator shall apply for a new approval in the case of change in address or ownership. The operator shall be subject to all fees.

(F) An operator shall post the current approval in a conspicuous manner on the business premises.

Sec. 4785.051. (A)(1) In conjunction with a specific event, a body modification business operator may seek a time-limited license from the board of health overseeing the jurisdiction in which the event will occur, enabling the operator to practice body modification at the event in question.

(2) Time-limited body modification establishments may be permitted at such events as fairs and other time-limited gatherings of people, if the board of health determines that the operator can substantially meet provisions contained in this chapter.

(3) The applicable board of health may accept the business's current approval as evidence of the ability to substantially meet the provisions contained in this chapter.

(4) While accepting the approval of another board of health, the board of health in the jurisdiction in which a body modification business seeks time-limited approval shall conduct an inspection of the site in which the operator intends to conduct the time-limited business to ensure that local standards will be met.

(B) Businesses that do not have current approval from a board of health shall apply for time-limited approval from the board of health in the jurisdiction in which the specific, time-limited event shall take place. The applicant shall submit all applicable fees and information the board of health determines necessary to process the application. The requested information shall assure the board of health that the business is capable of meeting the provisions of this chapter, the rules adopted pursuant to it, and local standards. The board of health in the jurisdiction in which a body modification business seeks time-limited approval shall conduct an inspection of the site in which the operator intends to conduct the time-limited business to ensure that local standards will be met.

(C) Any operator seeking a time-limited license under this section shall obtain a transient-vendor license from the department of taxation, as required under section 5739.17 of the Revised Code, prior to seeking a time-limited license under this section.

(D)(1) Except as provided in division (D)(2) of this section, only individuals who are licensed as body modification practitioners according to this chapter shall be allowed to provide body modification services under a time-limited license.

(2) The body modification board shall adopt rules for reviewing and accepting the credentials of an individual who is licensed or otherwise certified to provide body modification services in another state.

(E)(1) The board of health in the jurisdiction in which the operator is seeking a time-limited license shall charge a fee of two hundred dollars, enabling not more than five body modification practitioners to provide body modification services at the event in question.

(2) Additional practitioners may provide body modification services under the time-limited license for an additional fee of fifteen dollars per practitioner.

(F) Time-limited licenses shall not be issued for operators seeking to provide body modification services in an open-air setting.

Sec. 3730.04 4785.06.  A The local board of health shall conduct at least one inspection of a body modification business prior to approving the business under section 3730.03 4785.05 of the Revised Code to offer tattooing or body piercing modification services and shall conduct an inspection annually thereafter. The board may conduct additional inspections as necessary for the approval process. A board of health and may inspect an approved business at any time the board considers necessary. The board of health, or an authorized representative of the board, shall have the authority to enter a body modification business at any reasonable time to conduct inspections and to inspect procedures and conditions relating to the enforcement of this chapter and the rules adopted pursuant to it. In an inspection, a board of health shall be given access to the business's premises and to all records relevant to the inspection.

Sec. 3730.05 4785.07. (A) A local board of health may deny, suspend, or revoke the approval of a business to offer tattooing or body piercing modification services at any time the board determines that the business made any material misrepresentation to the board, does not meet or no longer meets, or has a history of noncompliance with the requirements of this chapter, or is being operated in violation of this chapter or the rules adopted under section 3730.10 of the Revised Code. Proceedings for suspensions and revocations shall be conducted in accordance with rules adopted under this section 3730.10 of the Revised Code.

(B) If a local board of health proposes to deny, suspend, or revoke an approval, the board shall provide the business with written notice of the proposed action and the cause for the action. The notice shall describe the procedure for appealing the proposed denial, suspension, or revocation.

(1) The notice shall be provided either by certified mail, return receipt requested, or by hand delivery. If the notice is returned due to failure of delivery, the board of health shall either send the notice by regular mail to the business location listed on the application or conspicuously post the notice at the entrance of the business. The notice is considered received by the intended recipient on the date it was mailed or posted.

(2) The notice shall state that the business may obtain a hearing under this section if a written request for a hearing is mailed or hand-delivered to the board of health's address specified in the notice, within fifteen days after the affected business receives or is considered to have received the notice.

(C) Upon receiving the notice in a timely manner, the local board of health shall schedule a hearing before the board or a hearing officer designated by the board. If the board provides a hearing officer, that hearing officer shall be licensed to practice law in this state and shall not have participated in any manner in the decision to take the action against the operator.

(1) The board shall mail or hand-deliver notice of the date, time, and place of the hearing to the operator not less than ten days before the scheduled date. The board may additionally post the notice of hearing at the entrance of the business.

(2) The business and the board of health each shall have one opportunity to reschedule the hearing date upon specific request to the hearing officer, or if a hearing officer has not been designated, to the other party. Any other postponements of the hearing shall be by agreement of the board of health, the business, and the hearing officer, if one is designated.

(D) At the hearing, the business shall have the opportunity to present its case orally or in writing and to confront and cross-examine adverse witnesses. The business may be represented by its counsel, if desired, and may review the case record before the hearing. If the local board of health has designated a hearing officer, a member of that board does not have to be present at the hearing.

(E) If the hearing is before a hearing officer, the hearing officer shall prepare a written recommendation as to the validity of the board of health's action, which shall rest solely on the evidence presented at the hearing and the statutory and regulatory provisions governing the action of the board of health. The hearing officer shall describe the basis for the recommendation, but need not prepare a full opinion or formal findings of fact and conclusions of law. The hearing officer shall send by certified mail, return receipt requested, or hand-deliver the recommendation to the board of health and the operator. Either party may file objections to the recommendation provided that the objections are received by the board of health within five days of receiving a copy of the recommendation from the hearing officer.

(F) If the board of health receives a timely objection, the board may by motion take additional evidence or approve, modify, or disapprove the recommendation and shall enter an order in the record of its proceedings. If the board of health does not receive a timely request for hearing, the board may immediately enter an order as proposed in the notice.

(G) Notwithstanding divisions (A) to (F) of this section, a board of health may immediately suspend the approval of a business operating in its jurisdiction for a violation presenting an immediate danger to the public health. The board shall provide the business with written notice of the action, the cause of the action, and the effective date of the action. The written notice shall specify the procedure for appealing the suspension and shall list the address to which a hearing request shall be sent or delivered. The business may appeal the suspension by mailing or hand-delivering a written request for hearing to the address specified in the notice. If a hearing is requested, it shall be heard not later than two business days after the request is received by the board of health. At the hearing, the business shall have the opportunity to present its case orally or in writing and to confront and cross-examine adverse witnesses. The business may be represented by its counsel, if desired, and may review the case record before the hearing. At the hearing, the board of health shall determine whether the immediate danger to the public health continues to exist.

(H) Any determination made or order entered by a board of health pursuant to this section shall be made by a majority vote of the members of the board present at a meeting at which there is a quorum. If the board conducts the hearing, the board may immediately render a decision denying, suspending, or revoking approval, or render a decision removing or continuing an approved suspension. The determination or order may be considered and made at a meeting without publication or advertisement, and may become effective without such publication or advertisement. An order is not effective until it is recorded in the board of health's record of its proceedings.

Sec. 3730.06 4785.08.  (A) No Subject to division (C) of this section, no person shall perform a tattooing procedure, body piercing modification procedure, or ear piercing procedure with an ear piercing gun on an individual who is under sixteen years of age or older and less than eighteen years of age unless consent has been given by the individual's parent, guardian, or custodian in accordance with division (B)(D) of this section.

(B) No person shall perform a body modification procedure on an individual who is under sixteen years of age, unless consent has been given by the individual's parent, guardian, or custodian and the procedure is a culturally-associated practice.

(C) No person shall perform a body modification procedure on the nipple, areola, or genital area of an individual who is under eighteen years of age, unless consent has been given by the individual's parent, guardian, or custodian and the procedure is a culturally-associated practice.

(D) A parent, guardian, or custodian of an individual under age eighteen described in division (A) of this section who desires to give consent to a business to perform on the individual under age eighteen a tattooing procedure, body piercing modification procedure, or ear piercing procedure performed with an ear piercing gun shall do both of the following:

(1) Appear in person at the business at the time and for the duration that the procedure is performed;

(2) Sign a document provided by the business that explains the manner in which the procedure will be performed, the specific part of the body upon which the procedure will be performed, and methods for proper care of the affected body area following performance of the procedure.

The parent, guardian, or custodian present must show proof of the legal relationship between the parent, guardian, or custodian and the individual described in division (A) of this section by providing a government-issued photo identification card and, if necessary, proof of legal guardianship.

Sec. 3730.07 4785.09.  (A) No individual shall knowingly show or give any false information as to the name, age, or other identification of an individual who is under age eighteen for the purpose of obtaining for the individual under age eighteen a tattooing service, body piercing modification service, or ear piercing service performed with an ear piercing gun.

(B) No individual shall impersonate the parent, guardian, or custodian of an individual who is under age eighteen for the purpose of obtaining for the individual under age eighteen a tattooing service, body piercing modification service, or ear piercing service performed with an ear piercing gun.

Sec. 3730.08 4785.10.  (A) An operator or employee of a business that performs tattooing services, body piercing modification services, or ear piercing services performed with an ear piercing gun may not be found guilty of a violation of division (A), (B), or (C) of section 3730.06 4785.08 of the Revised Code or any rule adopted under section 3730.10 of the Revised Code pursuant to this chapter in which age is an element of the provisions of the rule, if the local board of health or any court of record finds all of the following:

(1) That the individual obtaining a tattooing service, the body piercing modification service, or ear piercing service performed with an ear piercing gun, at the time of so doing, exhibited to the operator or employee of the tattooing, body piercing, modification or ear piercing business a driver's or commercial driver's license or an identification card issued under sections 4507.50 to 4507.52 of the Revised Code showing that the individual was then at least age eighteen;

(2) That the operator or employee made a bona fide effort to ascertain the true age of the individual obtaining a tattooing, the body piercing, modification service or ear piercing service performed with an ear piercing gun by checking the identification presented, at the time of the service, to ascertain that the description on the identification compared with the appearance of the individual and that the identification had not been altered in any way;

(3) That the operator or employee had reason to believe that the individual obtaining a tattooing, the body piercing, modification service or ear piercing service performed with an ear piercing gun was at least age eighteen.

(B) In any hearing before a board of health and in any action or proceeding before a court of record in which a defense is raised under this section, the registrar of motor vehicles or the registrar's deputy who issued a driver's or commercial driver's license or an identification card under sections 4507.50 to 4507.52 of the Revised Code shall be permitted to submit certified copies of the records, in the registrar's or deputy's possession, of such issuance in lieu of the testimony of the personnel of the bureau of motor vehicles at such hearing, action, or proceeding.

Sec. 3730.09 4785.11.  (A) Each operator of a business that offers tattooing or body piercing services modification establishment shall do all of the following:

(1) Maintain procedures for ensuring that the individuals who perform tattooing or body piercing modification procedures are licensed pursuant to section 4785.03 of the Revised Code and are adequately trained to perform the procedures properly;

(2) With respect to tattooing services, maintain Maintain written records that include the color, manufacturer, and lot number of each pigment used for each tattoo performed as required by this chapter and rules adopted pursuant to it, including all information required for approval under section 4785.05 of the Revised Code;

(3) Comply with the safety and sanitation requirements for preventing transmission of infectious diseases, as established in by this chapter and any rules adopted under section 3730.10 of the Revised Code pursuant to it;

(4) Ensure that all invasive equipment or parts of equipment used in performing tattooing and body piercing modification procedures are disinfected and sterilized by using methods that meet the disinfection and sterilization requirements established in by this chapter and any rules adopted under section 3730.10 of the Revised Code pursuant to it;

(5) Ensure that weekly biweekly tests of the business's heat sterilization devices are performed to determine whether the devices are functioning properly. In having the devices tested, the operator of the business shall use a biological monitoring system that indicates whether the devices are killing microorganisms. If a test indicates that a device is not functioning properly, the operator shall take immediate remedial action to ensure that heat sterilization is being accomplished. The operator shall maintain documentation that the weekly biweekly tests are being performed. To comply with the documentation requirement, the documents must consist of a log that indicates the date on which each test is performed and the name of the person who performed the test or, if a test was conducted by an independent testing entity, a copy of the entity's testing report. The operator shall maintain records of each test performed for at least two years. Within one year of the effective date of this amendment, submit, to the local board of health for approval, a written infection prevention and control plan as described in section 4785.05 of the Revised Code. The plan shall be kept up to date and resubmitted to the board of health as necessary.

(B) Each operator of a body modification establishment shall ensure the establishment complies with all of the following:

(1) The premises has an area of at least four hundred square feet and the floor space for each individual performing body modification services has an area of at least thirty six square feet. These areas shall be adequately spaced or separated from each other by fixed partitions. Complete privacy shall be available upon a patron's request and private sessions after hours shall be available.

(2) The entire procedure room and all equipment are maintained in a clean, sanitary condition and in good repair.

(3) A minimum of at least twenty foot candles of artificial light at a distance of thirty inches above the floor are provided throughout the establishment and a minimum of forty foot candles of light are provided at the level where the body modification is being performed. Spotlighting may be used to achieve this required degree of illumination.

(4) All floors directly under equipment used for body modification have an impervious, smooth, and washable surface.

(5) All tables and other equipment are constructed of easily cleanable material, with a smooth, nonporous finish.

(6) Restroom facilities are available to the body modification practitioners and patrons and are located within the establishment. The restroom shall be accessible at all times the body modification establishment is open for operation. The restroom shall be equipped with a toilet, toilet paper installed in a holder, hand washing sink supplied with hot and cold running water, liquid or granulated soap, and single-use towels or mechanical hand dryer. Equipment and supplies used for body modification procedures or disinfection and sterilization procedures shall not be stored or utilized within the restroom.

(7) A hand washing sink, with hot and cold running water, liquid or granular soap, and single-use towels or a mechanical hand dryer is located separate from the restroom and no further than twenty-five feet from each body modification practitioner performing a procedure.

(8) No overhead or otherwise exposed sewerage lines exist so as to create a potential hazard to the sanitary environment of the business.

(9) Sufficient and appropriate receptacles are provided for the disposal of used gloves, dressings, and other trash. Each receptacle shall have a lid and be kept closed at all times while not in use.

(10) Animals are not permitted in the establishment. This requirement does not apply to patrol dogs accompanying security or police officers, guide dogs, or other support animals accompanying disabled persons.

(11) Unless medically necessary, no person consumes food or drink, handles contact lenses, applies cosmetics, performs personal grooming, handles personal vaporizing devices, or conducts other similar activities in rooms used specifically for body modification or sterilization procedures.

(12) Smoking or use of any other tobacco product, including an electronic cigarette or personal vaporizer, is not permitted in facilities used specifically for tattoo or body piercing purposes.

(13) Smoking is not permitted within ten feet of the entryway of the facility.

(14) All water supplies, waste water disposal systems, solid waste disposal, and infectious waste disposal meet requirements of the Ohio environmental protection agency, the department of health, or the local board of health, as applicable.

(C) Each operator of a body modification establishment shall ensure that all persons performing body modification services in the establishment hold a valid license issued under section 4785.03 of the Revised Code.

(D) The operator of the body modification establishment shall ensure that each patron shall be provided with verbal and written aftercare guidelines following any body modification procedure. Such guidelines shall be available in both English and Spanish.

(E)(1) The operator of the body modification establishment shall ensure that record of each body modification procedure is maintained by the body modification establishment for at least two years. The record shall include all of the following:

(a) The patron's name;

(b) The patron's address;

(c) The date of the service;

(d) The colors and manufacturer of all inks, dyes, or pigments used;

(e) Any jewelry used, including size, material composition, and manufacturer;

(f) The placement of the procedure.

(2) In the event of the closing of the establishment, the operator shall, in accordance with federal law, make all records available to the local board of health.

(F) Each operator of a business that offers ear piercing services performed with an ear piercing gun shall require the individuals who perform the ear piercing services to disinfect and sterilize the ear piercing gun by using chemical solutions that meet the disinfection and sterilization requirements established in rules adopted under section 3730.10 of the Revised Code comply with section 4785.17 of the Revised Code and any rules adopted pursuant to this chapter.

Sec. 4785.12. (A) No body modification practitioner shall perform body modification services if either of the following applies:

(1) The body modification practitioner is impaired by any drugs or alcohol;

(2) The body modification practitioner knowingly has, in a communicable stage, an infectious or contagious disease, parasitic infestation, exudative lesions, or any form of communicable weeping dermatitis. If the practitioner has such a condition, the practitioner shall avoid contact with patrons and equipment until the condition is healed or is noncommunicable, as relevant. Any cuts, sores, or abrasions shall be adequately covered with a bandage.

(B) Prior to performing a body modification procedure, the body modification practitioner shall inquire of a patron if the patron has any condition that could affect the healing process. Body modification procedures shall not be performed on patrons that indicate the presence of such a condition without documentation from a licensed physician indicating acceptance of the patient for appropriate care following the procedure.

(C) A body modification practitioner shall perform body modification procedures only on a healthy skin surface, as specified by the body modification board in rules.

(D) A body modification practitioner performing body modification procedures shall observe standard precautions for preventing transmission of bloodborne and other infectious diseases including compliance with all of the following:

(1) Sterile instruments and aseptic techniques shall be used at all times during a procedure;

(2) Hand washing shall be performed before and after each procedure and as otherwise required in rules adopted by the board.

(3) Fingernails shall be kept short and clean in accordance with rules adopted by the board;

(4) Clean, previously unused gloves shall be worn throughout the entire procedure, including during setup and tear down. If the gloves are pierced, torn, or otherwise become contaminated or compromised, hand washing shall be performed and a new pair shall be put on immediately. If the body modification practitioner leaves the area during the procedure, gloves shall be removed before leaving, hand washing shall be performed, and a new pair of gloves shall be put on when returning. Under no circumstances shall a single pair of gloves be used on more than one patron. Nitrile gloves should be available for use on patrons with a latex allergy.

(5) Only sterilized, single use, disposable needles shall be used on a patron. All used needles and associated needle bars shall be properly disposed of immediately after the procedure.

(6) A body modification practitioner performing a tattoo procedure who utilizes a control barrier must use a new, disposable control barrier for each patron.

(7) If shaving is necessary, single use disposable razors shall be used. No straight razors shall be used. Used razors shall be properly disposed of in an appropriate sharps container.

(8) Only pre-dispensed A&D ointment, triple antibiotic ointment, or an industry specific ointment shall be used in area of a tattoo before, during, and after the procedure and shall be applied by pre-sterilized gauze or tongue depressors. Under no circumstances are fingers to be used for this purpose.

(9) All marking instruments shall be antiseptic in nature or sterilize by design.

(10) All products used to address the flow of blood or to absorb blood shall be single use and disposed of properly. No body modification practitioner performing a body modification procedure shall use styptic pencils, alum blocks, or other solid styptics to address the flow of blood.

(11) After any body modification service and prior to the next, all procedure areas shall be cleaned according to procedures and with chemicals approved by the board in rule.

(12) All soaps, inks, dyes, pigments, ointments, and other products shall be dispensed and applied using an aseptic technique and in a manner to prevent contamination of the original container and its contents. Applicators shall be antiseptic in nature or sterile by design.

(13) Any equipment intended for use that is not single use shall be disinfected and sterilized between patrons. Equipment that cannot be sterilized shall be disinfected between each use.

(14) Appropriate hand washing techniques shall be followed and gloves shall be worn during cleaning, disinfecting, and sterilization procedures.

(15) Waste items, including needles, razors, and other supplies capable of causing lacerations or puncture wounds, generated through the provision of any body modification procedure, shall be disposed of in accordance with rules adopted by the board.

(16) Piercings shall be conducted using a lubricating, water-based jelly.

(E) If a complaint of infection is directly related to the body modification procedure in question, the body modification practitioner who performed the procedure shall cooperate with any investigations or requirements of the local board of health.

Sec. 4785.14.  Each operator of a body modification establishment shall ensure that the business and all body modification practitioners performing in the establishment comply with all the following:

(A) All nondisposable instruments or equipment used for body modification procedures shall be thoroughly cleaned and sterilized or disinfected after each use on any patron in the following manner:

(1) Soaked in an enzymatic precleaner to remove all gross debris;

(2) Scrubbed of debris;

(3) Rinsed and patted dry;

(4) Disassembled or placed in the open position, if hinged;

(5) Visually inspected to verify that they are clean and to identify any damage including bends, cracks, or pits that would impair the sterilization process;

(6) Thoroughly cleaned in tepid water and an appropriate detergent capable of breaking down blood, ink, dyes, pigments, and other contaminants;

(7) Fully submerged in a disinfectant to ensure contact with all surfaces for the amount of time specified in the manufacturer's instructions;

(8) Rinsed and patted dry;

(9) Placed in a heated ultrasonic cleaning unit filled with an appropriate solution;

(10) Rinsed and air dried;

(11) Individually packed in sterilization pouches or sealable nylon sterilization tubing. Each pouch or its indicator shall be labeled with autoclave indicating tape. The label shall note the date and time of processing as well as the initials of the operator.

(B) All nondisposable instruments or equipment used for body modification procedures shall be steam sterilized before each use on any patron to a pressure of at least fifteen pounds per square inch. Once this pressure has been reached, the equipment shall be sterilized for thirty minutes.

(C) All ultrasonic cleaning units and steam sterilizers shall be used, cleaned, and maintained in accordance with the manufacturer's current instructions. The sterilizer shall be maintained in proper working condition and records of any maintenance performed shall be kept for at least two years.

(D) All sterilizers shall be monitored by using all of the following:

(1) Sterilization pouches that have a process indicator that changes color upon proper steam sterilization;

(2) A sterilization integrator placed in each load or a digital printout from the sterilizer of each load in accordance with the manufacturer's recommendations, indicating that minimum conditions existed;

(3) A biological indicator test that is taken and submitted to a lab for analysis on a weekly basis for businesses with forty or more pounds of medical waste per week or on a monthly basis for businesses with less than forty pounds of medical waste per week.

(E)(1) Documentation that the sterilization indicators, integrators, and biological indicator tests were performed shall be maintained and shall include all of the following:

(a) The date and time the sterilizer load was run or the biological test was performed;

(b) The name of the person who ran the sterilization load or performed the test;

(c) The results of the sterilization integrator or digital printout;

(d) A copy of the report that a biological indicator test was conducted by an independent laboratory.

(2) All documentation records shall be maintained and readily available for each test performed for at least two years. This documentation may also be kept in each patron's file for all needles and instruments used on that patron.

(F) All steam sterilizers in body modification establishments shall be designed to sterilize hollow instruments and shall be equipped with a mechanical drying cycle.

(G) When any wetness or moisture remains on or within a sterilization pouch, or if the sterilizer has malfunctioned, the instruments or equipment shall be considered contaminated and shall be repackaged and resterilized in a functioning sterilizer prior to use.

(H)(1) When the process indicator in the pouches and sterilization integrators or digital printout demonstrate that sterilization has been achieved, the sterilized instruments and equipment shall remain in the pouches and be placed into inventory until use.

(2) When the process indicator in the pouches, the sterilization integrator, or the digital printout demonstrate that sterilization has not been achieved, the sterilizer shall not be used until it is examined to determine the malfunction and repaired or replaced.

(I) After sterilization, all equipment and instruments used for body modification shall remain in the sterilization pouch, handled with newly gloved hands and stored in a clean, dry, closed cabinet, drawer, or other container reserved for such instruments or equipment. Sterilized instruments or equipment shall not be used until reprocessed if the integrity of the pouch has been compromised, is wet or stained, or is otherwise contaminated.

(J) The board shall adopt rules specifying that the expiration date for steam-sterilized equipment or instruments is one year from the date of sterilization, unless the integrity of the sterilization pouch is compromised and prescribing expiration dates for equipment or instruments sterilized using other methods.

(K) All tattoo needles or instruments intended to penetrate the skin only once shall be disposed of after one use.

Sec. 4785.15.  In addition to other requirements of this chapter, an operator of a body modification establishment shall ensure that the business and all persons performing tattooing procedures at that establishment comply with all of the following:

(A) Prior to a procedure, the area of the patron's body to be tattooed, shall be thoroughly cleaned with soap and water, then prepared with an antiseptic solution that is applied with a clean single-use gauze square, cotton ball or square, cotton swab, or other clean, absorbent, disposable material.

(B) All products applied to the skin, including stencils, shall be single use and disposable. Stencils shall be dispensed and applied on the area to be tattooed with a clean paper towel or an applicator in a manner to prevent contamination of the original container and its contents. Petroleum-based products shall not be used in conjunction with latex gloves.

(C) Only commercially manufactured inks, dyes, or pigments that are intended for tattooing shall be used. Powdered dyes shall be liquefied as recommended by the manufacturer. Unless approved by the manufacturer, ink, dye, or pigment colors shall not be adulterated by the body modification practitioner. Single-use containers of inks, dyes, or pigments, including for mixing, shall be used for each patron, and the body modification practitioner shall discard the container and remaining dye or ink upon completion of procedure. If nondisposable containers are used, they shall be sterilized before reuse. The body modification practitioner performing the procedure shall remove excess dye, pigment, or ink from the skin with single-use gauze squares, cotton balls or squares, cotton swabs, or other clean, absorbent, disposable material.

(D) The body modification practitioner shall wash the completed tattoo with a single-use gauze square, cotton ball, or square or cotton swab, saturated with an appropriate A&D ointment, triple antibiotic ointment, or industry specific ointment dispensed and applied by presterilized gauze. The tattooed area shall be allowed to dry, after which the body modification practitioner shall apply a sterile, nonocclusive, single-use dressing secured with nonallergenic tape to the site. Nonmedical use paper products, including napkins and tape for dressing, shall not be used.

(E) Gloves shall be worn for all procedures required under this section.

Sec. 4785.16.  In addition to other requirements of this chapter, an operator of a body modification establishment shall ensure that the business and all persons performing body piercing services at that establishment comply with all of the following:

(A) Prior to a procedure, the area of the patron's body to be pierced shall be thoroughly cleaned with a mixture of antibacterial soap, benzalkonium chloride, and seventy per cent isopropyl alcohol, then prepared with an antiseptic solution that is applied with a clean, absorbent disposable material. In the case of oral piercings, the patron shall be provided with alcohol-free, antiseptic mouthwash in a single-use cup and the body modification practitioner shall ensure that the patron utilizes the mouthwash provided to thoroughly rinse the affected area. In the case of a lip, labret, or cheek piercing, procedures described in this division for both skin and oral piercings shall be followed.

(B) Only sterilized jewelry made of a material approved by the board in rule shall be placed in a new piercing.

(C) Body modification operators producing jewelry in-house shall maintain mill certificates for jewelry at the body modification establishment.

Sec. 4785.17.  An operator of a business that provides ear piercing services with an ear piercing gun shall ensure that the business and all persons performing those services at that business comply with all of the following:

(A) All individuals providing ear piercing services with an ear piercing gun shall be trained in accordance with the manufacturer's specifications to properly use, clean, disinfect, sterilize, and store the ear piercing gun, in accordance with rules adopted pursuant to this chapter.

(B) The ear piercing gun shall only be used on the lobe of the ear.

(C) The individual performing the service shall wear a clean, new pair of gloves for each piercing performed.

(D) The ear piercing gun shall be made up of disposable parts, such that all parts of the gun that touch the patron's skin are disposable and can be removed from the gun and disposed of in an appropriate receptacle.

(E) In the case of a visible exposure of the gun to blood, the individual performing the service shall immediately do one of the following:

(1) Place the gun in a rigid, tightly closed container, before returning the gun to the manufacturer, in accordance with instructions provided by the manufacturer;

(2) Sterilize the gun by the procedure established in section 4785.14 of the Revised Code;

(3) Discard the gun in accordance with solid waste and infectious waste rules adopted by the Ohio environmental protection agency.

(F) After proper sterilization, the ear piercing gun shall be stored in a sterilization bag in a covered container or cabinet when not in use.

(G) Prior to performing an ear piercing procedure with an ear piercing gun, the individual offering the service shall inform all patrons requesting such services of the frequency and method utilized to disinfect and sterilize all equipment used in the ear piercing procedure and the extent to which the methods used destroy disease-producing microorganisms.

(H) The individual offering the service shall provide aftercare guidelines that shall not include the use of bezalkonium chloride for more than three days after the completion of the procedure.

(I) An operator that provides ear piercing services shall abide with the consent requirements prescribed in division (A) of section 4785.08 of the Revised Code.

Sec. 3730.11 4785.18.  Nothing in this chapter shall be interpreted as prohibiting municipal corporations, or townships that have adopted the limited self-government form of township government under Chapter 504. of the Revised Code, from adopting ordinances or resolutions that prohibit the establishment of businesses that offer tattooing or body piercing services modification procedures.

Sec. 3730.99 4785.99.  (A) Whoever Except as provided in division (E) of this section, whoever violates division (A), (B), or (C) of section 3730.02 or division (A) of section 3730.06 4785.02 of the Revised Code is guilty of a misdemeanor of the fourth degree.

(B) Whoever violates division (A) or (B) of section 3730.07 4785.09 of the Revised Code is guilty of a misdemeanor of the first degree.

(C)(1) Except as provided in divisions (D) and (E) of this section, whoever violates division (A), (B), or (C) of section 4785.08 of the Revised Code is guilty of a misdemeanor of the first degree on a first offense, a felony of the fifth degree on a second offense, a felony of the fourth degree on a third offense, and a felony of the third degree on a fourth or subsequent offense.

(2) The penalties for the offenses described in division (C)(1) of this section shall be the following:

(a) For a misdemeanor of the first degree, a fine of up to five hundred dollars or a jail term of one hundred eighty days, or both;

(b) For a felony of the fifth degree, a fine of up to one thousand dollars or a prison term of between six and twelve months, or both;

(c) For a felony of the fourth degree, a fine of up to five thousand dollars or a prison term of between twelve and eighteen months, or both;

(d) For a felony of the third degree, a fine of up to ten thousand dollars or a prison term of between thirty-six and sixty months, or both.

(D) Whoever violates division (B) or (C) of section 4785.08 of the Revised Code by performing a body modification procedure or ear piercing procedure with an ear piercing gun on an individual who is under thirteen years of age is guilty of a felony of the first degree and may be fined up to twenty thousand dollars and sentenced to a prison term of between five and eleven years, or both.

(E) Whoever violates division (A) of section 4785.02 and division (A), (B), or (C) of section 4785.08 of the Revised Code in the same course of conduct is guilty of a felony of the second degree and may be fined up to fifteen thousand dollars and sentenced to a prison term of between five and eleven years in prison.

Section 2.  That existing sections 3709.09, 3730.01, 3730.02, 3730.03, 3730.04, 3730.05, 3730.06, 3730.07, 3730.08, 3730.09, 3730.11, and 3730.99 and section 3730.10 of the Revised Code are hereby repealed.

Section 3. (A) The Department of Health and the Governor shall make their initial appointments to the State Board of Body Modification pursuant to section 4785.03 of the Revised Code, as enacted by this act, by December 1, 2014.

(B) The requirement in division (A) of section 4785.03 of the Revised Code, as enacted by this act, that three members of the State Board of Body Modification be body modification practitioners licensed under Chapter 4785. of the Revised Code, as enacted by this act, shall not apply to initial appointments to the Board. Instead, those members shall be individuals with sufficient experience in the provision of body modification services.

Section 4. Section 3730.02 (4785.02) of the Revised Code, as amended by this act, shall take effect one hundred eighty days after the effective date of this act.

Section 5. The Director of Health shall coordinate with the State Board of Body Modification for the revision, and potential renumbering, of Chapter 3701-9. of the Ohio Administrative Code to ensure that the Ohio Administrative Code is consistent with this act. The Director may adopt, amend, and repeal rules in that Chapter for this purpose.

Section 6. The requirement related to steam sterilizers prescribed in division (F) of section 4785.14 of the Revised Code shall not apply to body modification operators or establishments existing on the effective date of this act until January 1, 2017.