Section 3-1201.02 - Definitions of health occupationsFor the purposes of this chapter, the term:
(1) "Practice of acupuncture" means the insertion of needles, with or without accompanying electrical or thermal stimulation, at a certain point or points on or near the surface of the human body to relieve pain, normalize physiological functions, and treat ailments or conditions of the body. A licensed acupuncturist does not need to enter into a collaboration agreement with a licensed physician or osteopath to practice acupuncture.(1A) "Practice of addiction counseling" means providing services, with or without compensation, based on theory and methods of counseling, psychotherapy, and addictionology to persons who are experiencing cognitive, affective, or behavioral psycho-social dysfunction as a direct or indirect result of addiction, chemical dependency, abuse of chemical substances, or related disorders. The practice of addiction counseling includes:(A) Addiction prevention;(F) Follow-up, which is rendered to individuals, families, groups, organizations, schools, and communities adversely affected by addictions or related disorders; and(G) The education and training of persons in the field of addiction counseling.(2) "Practice of advanced practice registered nursing" means the independent performance of advanced-level nursing actions, with or without compensation, by a licensed registered nurse with advanced education, knowledge, skills, and scope of practice who has been certified to perform such actions by a national certifying body acceptable to the Board of Nursing in the appropriate advanced practice registered nursing role and in at least one population focus. Advanced practice registered nursing shall include the categories of certified registered nurse anesthetist, certified nurse-midwife, certified nurse-practitioner, and clinical nurse specialist. The practice of advanced practice registered nursing includes: (D) Selecting, administering, and dispensing therapeutic measures;(E) Treating alterations of the health status; and(F) Carrying out other functions identified in Title VI and in accordance with procedures required by this act.(2A)(A) "Practice by anesthesiologist assistants" means assisting an anesthesiologist in developing and implementing anesthesia care plans for patients under the supervision and direction of the anesthesiologist.(B) For the purposes of this paragraph, the term "anesthesiologist" means a physician who has completed a residency in anesthesiology approved by the American Board of Anesthesiology or the American Osteopathic Board of Anesthesiology and who is currently licensed to practice medicine in the District of Columbia.(2A-i)(A) "Practice of assisted living administration" means planning, organizing, directing, and controlling the operation of an assisted living residence.(B) For the purposes of this chapter, the term:(i) "Assisted living administrator" or "ALA" means a person who oversees the day-to-day operation of the facility, including compliance with all regulations for licensed assisted living residences.(ii) "Assisted living residence" shall have the same meaning as provided in § 44-102.01(4). (2A-ii)(A) "Practice of athletic training" means any of the following:(i) The treatment of an athletic injury that is: (I) For an athlete whose condition is within the professional and educational ability of the licensed athletic trainer; and(II) Performed under the general supervision of a physician who has issued any written order, protocol, or recommendation for an athletic injury;(ii) The immediate treatment of athletic injuries, including common emergency medical situations;(iii) The provision of education, guidance, and counseling to athletes, coaches, parents of athletes, and athletic communities regarding athletic training and the prevention, care, and treatment of athletic injuries; and(iv) The organization and administration of athletic training programs.(B) Nothing in subparagraph (A) of this paragraph shall be construed as authorizing: (i) The rendering of a medical diagnosis or opinion regarding a physical disability or the use of X rays, radium, or electricity for cauterization or surgery by an athletic trainer;(ii) Treatment or rehabilitation of neurologic injuries, conditions, or disease other than the preventative and emergency medical treatment authorized by subparagraphs (A)(i) and (A)(ii) of this paragraph; and(iii) The expansion of treatment beyond the determination of the supervising physician.(C) Nothing in subparagraph (A) of this paragraph shall be construed as preventing or restricting:(i) The lawful practice of a licensed health care professional under the scope of his or her license; provided, that he or she does not hold himself or herself out as an athletic trainer;(ii) Self-care by a patient, the provision of basic first aid services by an individual, or the gratuitous care by a friend or family member who does not represent himself or herself as an athletic trainer;(iii) [Repealed by 2024 Amendment.](iv) Coaches and physical education instructors, health or recreation directors, health club or spa instructors, and water safety instructors that are supervising athletic activities, exercise, aerobics, weightlifting, water safety, and other recreational physical activities; provided, that the person does not represent himself or herself as an athletic trainer or provide athletic trainer services, and if any treatment of athletic injuries is limited to the provision of basic first aid;(v) The activities of athletic training students acting under the direction of an athletic trainer licensed, certified, or registered in any state; provided, that the students are designated by a title that clearly indicates their status as athletic training students; or(vi) The activities of athletic trainers from other nations, states, or territories when performing their duties for their respective teams or organizations and only during the course of their team's or organization's stay in the District; provided, that the athletic trainers are currently licensed, certified, or registered, in any state or Canada, or are currently certified by the National Athletic Trainers Association Board of Certification, Inc., or its successor.(D) For the purposes of this paragraph, the term:(i) "Athlete" means: (I) A person participating in, or preparing for a competitive team or individual sport or other athletic activity being conducted by an educational institution, professional athletic organization, or a board-sanctioned amateur athletic organization;(II) A member of an athletic team; or(III) Any physically active person seeking treatment for athletic injuries.(ii) "Athletic injury" means a musculoskeletal or orthopedic injury or other medical condition suffered by an athlete resulting from, or limiting participation in or training for scholastic, recreational, professional, amateur athletic activities, or other physical activities.(iii) "Treatment" means the prevention, evaluation, recognition, management, treatment, rehabilitation, or reconditioning of an athletic injury, including the usage of appropriate preventative and supportive devices, temporary splinting and bracing, physical modalities of heat, cold, light, massage, water, electric stimulation, sound, and passive or active exercise, temporary mechanical devices, mechanical equipment, or any other therapeutic modality for which an athletic trainer has received appropriate training or education.(E) Any person who holds a license pursuant to this chapter as an athletic trainer may use the letters "LAT" or "AT" in connection with the person's name to denote licensure hereunder, and unlicensed persons are prohibited from using in connection with their name or business activity the words "athletic trainer," "trainer," "certified athletic trainer," and "licensed athletic trainer." (2B)(A) "Practice of audiology" means the planning, directing, supervising, and conducting of habilitative or rehabilitative counseling programs for individuals or groups of individuals who have, or are suspected of having, disorders of hearing or balance; any service in audiology, including prevention, identification, evaluation, consultation, habilitation or rehabilitation, academic instruction, clinical instruction, and research; participating in hearing conservation, hearing aid and assistive listening device evaluation, selection, preparation, dispensing, and orientation; fabricating ear molds; cerumen management; interoperative neurophysiologic monitoring; providing auditory training and speech reading; administering tests of vestibular function or tinnitus; or speech and language screening limited to a pass-or-fail determination for the purpose of identification of individuals with disorders of communication and associated referral for management of communication and balance disorders, or cognitive, dexterity, depression, or vision screening, and associated referral for management of related disorders. The practice of audiology does not include the practice of medicine or osteopathic medicine, or the performance of a task in the normal practice of medicine or osteopathic medicine by a person to whom the task is delegated by a licensed physician.(2C) "Practice by an audiology assistant" means assisting a licensed audiologist in implementing audiology care and treatment plans for patients under the direct supervision and direction of the licensed audiologist.(2C-i) "Practice of behavior analysis" means the design, implementation, and evaluation of environmental modifications to produce socially significant improvement in human behavior, including the use of direct observation, measurement, and functional analysis of the relationship between environment and behavior.(2C-ii) "Practice of certified midwifery" means the provision of independent management of primary maternity and well-women care by a certified midwife licensed under this act to a patient-client in the normal course of childbirth, including prenatal, intrapartum, postpartum, and normal new-born care. The practice of certified midwifery includes: (A) Prescribing medications, including controlled substances and contraceptive methods;(B) Admitting, managing, and discharging patients;(C) Ordering and interpreting laboratory and diagnostic tests and ordering the use of medical devices in the course of care;(D) Consulting and treating in areas such as health promotion, family planning services, disease prevention, individualized wellness education and counseling, and primary care unrelated to childbirth; and(E) Management of common health problems that may require consultation, collaborative management, or referral as indicated by the health status of the patient-client, in accordance with standards established by the American College of Nurse-Midwives.(2D)(A) "Practice of certified professional midwifery" means the provision of primary maternity care and well-women care by a certified professional midwife licensed under this act to a patient-client during the preconception, antepartum, intrapartum, and postpartum periods. The practice of certified professional midwifery includes:(i) Discussing any general or specific risk factors pertaining to the health and circumstances of the patient-client associated with the provision of primary maternity care and well-women care;(ii) Consulting with the patient-client regarding the conditions under which consultation, transfer of care, or transport are necessary;(iii) Obtaining the patient-client's health history;(iv) Performing a physical examination of the patient-client;(v) Developing a written plan of care that must be provided to a patient-client and included in the medical record specific to the patient-client to ensure continuity of care throughout the antepartum, intrapartum, and postpartum periods, including an emergency birth plan;(vi) Consulting, collaborating, referring, or transferring care to appropriate health care professionals in accordance with the national standard of care;(vii) Providing care during the antepartum, intrapartum, postpartum, and newborn periods, including:(I) Monitoring and evaluating the condition of the patient-client;(II) Conducting the delivery of a fetus in an out-of-hospital setting or inpatient setting;(III) Suturing episiotomy or first and second-degree lacerations, including the administration of a local anesthetic; and(IV) Performing emergency procedures, including: (aa) Administering approved medications;(bb) Administering intravenous fluids for stabilization; and(cc) Performing an emergency episiotomy;(V) Providing routine care for a newborn, including immediate care at birth, the performance of newborn examination, and the administration of intramuscular vitamin K and eye ointment for prevention of ophthalmia neonatorum; and(VI) Providing limited care in between pregnancies to facilitate the continuity of care, including the provision of:(aa) Breastfeeding support and counseling;(bb) Family planning services, but only to the extent that such services will be limited to natural family planning and the provision of cervical caps and diaphragms in consultation with an appropriate health care provider as necessary; and(cc) Pap smears, but only to the extent that a patient-client with an abnormal pap smear result will be referred to an appropriately-licensed health care provider.(B) Subparagraph (A) of this paragraph 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, or licensed basic or advanced emergency medical technician.(C) Subparagraph (A) of this paragraph shall not be construed as preventing or restricting the practices, services, or activities of: (i) A licensed physician, licensed naturopathic physician, certified nurse-midwife, or licensed basic or advanced emergency medical technician;(ii) A member of an American Indian community who provides traditional midwife services to the member's community;(iii) Any person who, in good faith, engages in the practice of the religious tenets of any church or in any religious act if no fee is contemplated, charged, or received;(iv) Any person rendering aid in an emergency; or(v) A student midwife currently enrolled in an accredited midwifery education program and providing services to patient-clients under the direct, on-site, in-person supervision of a certified professional midwife.(D) Subparagraph (A) of this paragraph shall not be construed to authorize an individual licensed under this act to practice certified professional midwifery to:(i) Provide pharmacological induction or augmentation of labor;(ii) Conduct surgical delivery or any surgery except an emergency episiotomy;(iii) Utilize forceps or a vacuum extractor; except, that an individual licensed under this act to practice certified professional midwifery shall be authorized to administer a local anesthetic;(iv) Administer any kind of narcotic analgesic; or(v) Administer any prescription medication in a manner that violates the requirements of this act.(3)(A) "Practice of chiropractic" means practicing a primary care health discipline through the evaluation, examination, diagnosis, counseling, and treatment or management of biomechanical or physiological conditions or disorders that compromise neural integrity or organ system function; the use of x-rays and advanced diagnostic imaging, physical examination, and examination by instrumentation for the detection and correction of subluxations and somatic dysfunctions that cause vertebral, neuromuscular, or skeletal disorder; the adjustment of the spine or manipulation of bodily articulations for the restoration and maintenance of health; and the referral of a patient for diagnostic imaging, tests, and clinical laboratory procedures in order to determine a regimen of chiropractic care or to form a basis or referral of patients to other licensed health care professionals. The practice of chiropractic does not include the use of drugs or surgery but may include ancillary procedures such as dry needling in accordance with the rules and requirements promulgated by the Mayor.(B) Nothing in this paragraph shall be construed as preventing or restricting the services or activities of any individual engaged in the lawful practice of cosmetology or massage, provided that the individual does not represent by title or description of services that he or she is a chiropractor.(3A) "Practice of cytotechnology" means the microscopic study or examination of body fluids, tissues, cells desquamated from a body surface or lesion, or cells aspirated from a lesion for the practice of clinical laboratory science, including detecting malignancy and microbiologic changes and the measurement of hormonal levels.(4)(A) "Practice of dental hygiene" means the performance of any of the following activities in accordance with the provisions of subparagraph (B) of this paragraph:(i) A preliminary dental examination, including charting of cavities, soft tissue examination, periodontal examination, and oral cancer screening; a complete prophylaxis, including the removal of any deposit, accretion, or stain from the surface of a tooth or a restoration; debridement; scaling and root planing; soft tissue curettage; application of topical fluoride and fluoride varnish; and the polishing of a tooth or a restoration;(ii) Applying a medicinal agent to a tooth for a prophylactic purpose;(iii) Taking dental radiographs;(iv) Instructing individuals or groups of individuals in oral health care;(v) Administering local anesthesia and nitrous oxide when certified by the Board of Dentistry to do so;"(vi) Applying pit and fissure sealants;(vii) Placing and removing periodontal dressings;(viii) Administering vaccinations under the direct supervision of a dentist licensed under this act when certified by the Board of Dentistry to do so;(ix) Prescribing topical prescription or over-the-counter fluoride preparations and topical antimicrobial oral rinses, under the general supervision of a dentist licensed under this act;(x) Performing blood glucose testing;(xi) Placing or removing temporary restorations and crowns;(xii) Taking study cast impressions;(xiii) Removing sutures; and(xiv) Any other functions included in the curricula of approved educational programs in dental hygiene, including dental hygiene diagnosis.(B) Except for administering vaccinations, a dental hygienist may perform the activities listed in subparagraph (A) of this paragraph only under the general supervision of a licensed dentist, in their office or mobile dental clinic and in any public health setting, including a health care facility, correctional institution, residential facility, public school, shelter for victims of domestic abuse or runaways, foster home, nonprofit clinic, and long-term care facility rendering dental services as that term is defined in § 7-701.01(7). The Mayor may issue rules identifying specific functions authorized by subparagraph (A)(xiv) of this paragraph and may require higher levels of supervision for the performance of these functions by a dental hygienist. The license of a dentist who permits a dental hygienist, operating under his or her supervision, to perform any operation other than that permitted under this paragraph, may be suspended or revoked, and the license of a dental hygienist violating this paragraph may also be suspended or revoked, in accordance with the provisions of this chapter.(C) For the purposes of this paragraph, the term: (i) "Collaborative practice agreement" means a formal agreement between a licensed dentist and a licensed dental hygienist agreed upon by both parties that includes, at a minimum, the roles and responsibilities of each party, the ways in which they will collaborate, and the specific procedures, patient types, and protocols the dental hygienist must follow when practicing under the agreement.(ii) "Dental hygiene diagnosis" means the identification of an existing oral health problem that a dental hygienist is qualified and licensed to treat within the scope of the practice and focuses on behavioral risks and physical conditions related to oral health.(iii) "General supervision" means the performance by a dental hygienist of procedures permitted by subparagraph (A) of this paragraph based on instructions given by a dentist licensed under this act, but not requiring the physical presence of the dentist during the performance of these procedures. General supervision in dental clinics and public health settings shall be pursuant to a collaborative practice agreement, meeting the requirements set forth by the Mayor through rulemaking, with a dentist licensed under this act that designates authorization for the services provided by the dental hygienist; provided, that the dental hygienist has documented completion of a Board-approved course on medical emergencies within each continuing education cycle.(5) "Practice of dentistry" means:(A) The diagnosis, treatment, operation, or prescription for any disease, disorder, pain, deformity, injury, deficiency, defect, or other physical condition of the human teeth, gums, alveolar process, jaws, maxilla, mandible, or adjacent tissues or structures of the oral cavity, including the removal of stains, accretions, or deposits from the human teeth;(B) The extraction of a human tooth or teeth;(C) The performance of any phase of any operation relative or incident to the replacement or restoration of all or a part of a human tooth or teeth with an artificial substance, material, or device;(D) The correction of the malposition or malformation of the human teeth;(E) The administration of an appropriate anesthetic agent, by a dentist properly trained in the administration of the anesthetic agent, in the treatment of dental or oral diseases or physical conditions, or in preparation for or incident to any operation within the oral cavity;(F) The taking or making of an impression of the human teeth, gums, or jaws;(G) The making, building, construction, furnishing, processing, reproduction, repair, adjustment, supply or placement in the human mouth of any prosthetic denture, bridge, appliance, corrective device, or other structure designed or constructed as a substitute for a natural human tooth or teeth or as an aid in the treatment of the malposition of malformation of a tooth or teeth, or to advertise, offer, sell, or deliver any such substitute or the services rendered in the construction, reproduction, repair, adjustment, or supply thereof to any person other than a licensed dentist;(H) The use of an X-ray machine or device for dental treatment or diagnostic purposes, or the giving of interpretations or readings of dental X-rays;(I) The performance of any of the clinical practices included in the curricula of accredited dental schools or colleges or qualifying residency or graduate programs; or(J) To be a manager, proprietor, operator, or conductor of a business or place where dental or dental-hygiene services are performed; provided, that this provision shall not apply to: (i) Federal or District of Columbia government agencies providing dental services within affiliated facilities or engaged in providing public health measures to prevent disease;(ii) Schools of dentistry, dental hygiene, or dental assisting accredited by the Commission on Dental Accreditation of the American Dental Association and providing dental services solely in an educational setting;(iii) Federally Qualified Health Centers, as designated by the United States Department of Health and Human Services, providing dental services;(iv) Nonprofit community-based entities or organizations that use a majority of public funds to provide dental and dental-hygiene services for indigent persons;(v) Hospitals licensed by the Department of Health;(vi) Partnerships, professional corporations, or professional limited liability companies solely consisting of and operated by dentists licensed under this chapter for the purpose of providing dental services;(vii) Spouses and domestic partners of deceased licensed dentists for a period of one year following the death of the licensee;(viii) If all of the ownership interest of the deceased, licensed dentist in a dental office or clinic is held by an administrator, executor, personal representative, guardian, conservator, or receiver of the estate ("appointee"), the appointee may retain the ownership interest for a period of one year following the creation of the ownership interest; and(ix) An individual or entity acting as the manager, proprietor, operator, or conductor of a business or place where dental or dental-hygiene services are performed who does not have a license to practice dentistry and is not excepted pursuant to sub-subparagraphs (i) through (viii) of this subparagraph may continue to act as the manager, proprietor, operator, or conductor of the business or place where dental or dental-hygiene services are performed for a period of one year following July 7, 2009.(6)(A) "Practice of nutrition" means the application of the scientific principles derived from the study of food, nutrition, biochemistry, metabolism, physiology, and behavioral sciences for achieving and maintaining health throughout the lifespan; the provision of nutrition care services in-person or via telehealth, including medical nutrition therapy to prevent, manage, or treat diseases or medical conditions and promote wellness; the ordering of patient diets, including therapeutic diets via oral routes; the ordering of medical laboratory tests related to nutritional therapeutic treatments; and the provision of recommendations on vitamin, mineral, and other dietary supplements.(A-i) "Practice of dietetics" includes the entire scope of the practice of nutrition in subparagraph (A) of this paragraph, as well as the application of scientific principles derived from the study of nutrigenomics, pharmacology, and food systems management; the development and ordering of therapeutic diets, via oral, enteral, and parenteral routes; and the provision of advanced clinical nutrition care services consistent with current Scope and Standards of Practice for dietitians registered by the Commission on Dietetic Registration.(B) Nothing in this paragraph shall be construed as preventing or restricting the practices, services, or activities of dietetic technicians and dietetic assistants working under the supervision of a licensed dietitian or nutritionist, other health professionals licensed pursuant to this chapter, or other persons who in the course of their responsibilities offer dietary or nutrition information or deal with nutritional policies or practices on an occasional basis incidental to their primary duties, provided that they do not represent by title or description of services that they are dietitians or nutritionists.(C) For the purposes of this paragraph, the term "medical nutrition therapy" means the provision of any of the following nutrition care services for the purpose of management or treatment of a disease or medical condition: (i) Nutrition assessment;(ii) Nutrition diagnosis;(iii) Nutrition intervention; and(iv) Nutrition monitoring and evaluation.(6A) [Repealed by 2024 Amendment.](6A-i)[Repealed by 2024 Amendment.](6A-ii)(A) "Practice of home health care administration" means planning, organizing, directing, and controlling the provision of skilled and paraprofessional home health care, including related services, to individuals in out-of-hospital settings, such as private homes, boarding homes, hospices, and shelters.(B) For the purposes of this chapter, the term "home health care administrator" means a person who oversees the day-to-day operation of the provision of home health care, including compliance with all regulations for home care agency and home health agency administration.(6B)(A) "Practice of marriage and family therapy" means the diagnosis and treatment of mental and emotional disorders, whether cognitive, affective, or behavioral, within the context of, or arising from, marriage and family systems. The practice of marriage and family therapy involves the professional application of psychotherapeutic and family systems theories and techniques in the delivery of services to individuals, couples, and families, singly or in groups, whether the services are offered directly to the general public or through organizations, either public or private, for a fee, monetary or otherwise, for the purpose of treating the diagnosed nervous and mental disorders.(B) [Repealed by 2024 Amendment.](C) [Repealed by 2024 Amendment.](6B-i) [Repealed by 2024 Amendment.](6B-ii) [Repealed by 2024 Amendment.](6C)(A) "Practice of massage therapy" means the: (i) Performance of therapeutic maneuvers in which the practitioner applies massage techniques, including use of the hand or limb to apply touch and pressure to the human body through tapping, stroking, kneading, compression, friction, stretching, vibrating, holding, positioning, or causing movement of an individual's body to positively affect the health and well-being of the individual;(ii) Use of adjunctive therapies, including the application of heat, cold, water, and mild abrasives, but excluding galvanic stimulation, ultra sound, doppler vascularizers, diathermy, transcutaneous electrical nerve stimulation, or traction; and(iii) Education and training of persons in massage therapy techniques.(B) A licensed massage therapist shall not diagnose disease or injury; prescribe medicines, drugs, or other treatments of disease; or perform adjustments of the articulations of the osseous structure of the body or spine.(C) A licensed massage therapist may perform cross-gender massage.(6D) "Practice of medical assistants" means performing assistance with minor medical practices that, other than the administration of vaccines or other injections, do not involve any subcutaneous procedure and occur only under the direct supervision of a physician, physician assistant, or advance practice registered nurse.(6E) "Practice of medical radiation technology" means the use of ionizing or non-ionizing radiation for the purposes of medical imaging and treatment in any of the following categories:(A) The practice of cardiovascular-interventional technology, which means the use of imaging equipment to perform a comprehensive scope of invasive cardiac or neurological, peripheral, and visual cardiovascular and non-vascular diagnostic, therapeutic and interventional procedures that are displayed in radiographic or digital images for the purpose of assisting physicians in diagnostic and interventional procedures;(B) The practice of computed tomography technology, which means the use of ionizing radiation to produce tomographic images or slices of specific areas of the body on film, fluorescent material, or an image display device;(C) The practice of magnetic resonance technology, which means the use of resonance frequency within a magnetic field to evaluate anatomic of physiologic conditions of the body, perform spectral analysis, perform functional and anatomic analysis, and provide a basis for interventional or therapeutic procedures that utilize magnetic resonance technology;(D) The practice of mammography, which means the use of low-dose x-rays to image internal structures of the breast for purposes of detecting abnormal growths or cysts;(E) The practice of nuclear medicine technology, which means the use of in vivo and in vitro detection and measurement of radioactivity and the administration of radiopharmaceuticals and radionuclides for diagnostic and therapeutic purposes;(F) The practice of radiation therapy, which means the administration of ionizing and non-ionizing radiation to human beings for therapeutic purposes as prescribed and supervised by a radiation oncologist;(G) The practice of radiography, which means the use of ionizing radiation projected through the body to produce radiographic or fluoroscopic images;(H) The practice by radiologist assistants, which means the practice of radiography in the areas of patient care, patient management, clinical imaging and interventional procedures, but does not include interpreting images, making diagnoses, or prescribing medication or therapies; and(I) The practice of ultrasonography or sonography, which means the use of ultrasound for the visualization of subcutaneous body structures including tendons, muscles, joints, vessels, and internal organs for possible pathology or lesions.(7)(A) "Practice of medicine" means suggesting, recommending, prescribing, or administering, with or without compensation, any form of treatment, operation, drug, medicine, manipulation, electricity, or any physical, mechanical, or healing treatment by other means, for the prevention, diagnosis, correction, or treatment of a physical or mental disease, ailment, injury, condition, or defect of any person, including: (i) The management of pregnancy and parturition;(ii) The interpretation of tests, including primary diagnosis of pathology specimens, images, or photographs;(iii) Offering or performing a surgical operation upon another person;(iv) Offering or performing any type of invasive procedure of the body, whether through a body opening or a cutting of the skin, or otherwise affecting the layer of skin below the stratum corneum, for surgical, therapeutic, or cosmetic purposes, excluding procedures known as body tattooing or body piercing;(v) Rendering a written or otherwise documented medical opinion relating to the diagnosis and treatment of a person within the District, or the actual rendering of treatment to a person within the District, by a physician located outside the District as a result of transmission of the person's medical data by electronic or other means from within the District to the physician or to the physician's agent;(vi) Maintaining an office or other place for the purpose of examining persons afflicted with disease, injury, or defect of body or mind;(vii) Advertising or representing in any manner that one is authorized to practice medicine; or(viii) Using the designation "Doctor of Medicine," "Doctor of Osteopathy," "physician," "surgeon," "physician and surgeon," "M.D.," or "D.O.," or a similar designation, or any combination thereof, in the conduct of an occupation or profession pertaining to the prevention, diagnosis, or treatment of human disease or condition, unless the designation additionally contains the description of another branch of the healing arts for which one holds a valid license.(B) Nothing in this paragraph shall be construed as preventing or restricting other health professionals from offering or undertaking any type of invasive procedure of the body, whether through a body opening or a cutting of the skin, or otherwise affecting the layer of skin below the stratum corneum, for surgical, therapeutic, or cosmetic purposes, if the procedure: (i) Has been authorized by a licensed physician; or(ii) Is performed by an advanced practice registered nurse, an anesthesiologist assistant, a dentist, a physician assistant, a podiatrist, a practical nurse, a registered nurse, or a surgical assistant who has received the necessary training and experience to perform the procedure in a safe and effective manner.(C) Nothing in this paragraph shall be construed as preventing or restricting advanced practice registered nurses from performing their duties as advanced practice registered nurses.(7B) "Practice by nursing assistive personnel" means the performance by authorized individuals who have been assigned direct patient care tasks that are common to nursing functions and do not require professional skill or judgment within a health care, residential, or community support setting; provided, that the patient care tasks are performed under the general supervision of a licensed health care professional. Nursing assistive personnel includes: (D) Patient care technicians;(E) Trained medication employees;(F) Dialysis technicians; and(G) Any other profession as determined by the Mayor through rulemaking.(7C) "Practice by nursing assistive personnel" means the performance by unlicensed personnel of assigned patient care tasks that do not require professional skill or judgment within a health care, residential, or community support setting; provided, that the patient care tasks are performed under the general supervision of a licensed health care professional. Nursing assistive personnel includes: (E) Trained medication employees;(F) Dialysis technicians; and(G) Any other profession as determined by the Mayor through rulemaking.(8)(A) "Practice of nursing home administration" means the administration, management, direction, or the general administrative responsibility for an institution or part of an institution that is licensed as a nursing home.(B) Within the meaning of this paragraph, the term "nursing home" means a 24-hour inpatient facility, or distinct part thereof, primarily engaged in providing professional nursing services, health-related services, and other supportive services needed by the patient or resident.(9)(A) "Practice of occupational therapy" means: (i) The therapeutic use of everyday life activities and the use of other occupational therapy techniques to engage clients who have disability- or non-disability-related needs in everyday life occupations to enable participation in activities at home, school, the workplace, or other community settings to promote habilitation, rehabilitation, and health and wellness, with or without compensation;(ii) Addressing the physical, cognitive, psycho-social, sensory, or other aspects of performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life;(iii) The education and training of persons in the direct care of clients through the use of occupational therapy; and(iv) The education and training of persons in the field of occupational therapy.(B) An individual licensed as an occupational therapy assistant pursuant to this chapter may assist in the practice of occupational therapy under the general supervision of a licensed occupational therapist.(C) Nothing in this paragraph shall be construed as preventing or restricting the practices, services, or activities of an occupational therapy aide who works under the immediate supervision of a licensed occupational therapist or licensed occupational therapy assistant, and whose activities do not require advanced training in the basic anatomical, biological, psychological, and social sciences involved in the practice of occupational therapy.(10)(A) "Practice of optometry" means the application of the scientific principles of optometry in the examination of the human eye, its adnexa, appendages, or visual system, with or without the use of diagnostic pharmaceutical agents to prevent, diagnose, or treat defects or abnormal conditions; the prescription or use of lenses, prisms, orthoptics, vision training or therapy, low vision rehabilitation, therapeutic pharmaceutical agents, or prosthetic devices; or the application of any method, other than invasive surgery, necessary to prevent, diagnose, or treat any defects or abnormal conditions of the human eye, its adnexa, appendages, or visual system.(B) The Mayor shall issue rules identifying which, and under what circumstances, diagnostic and therapeutic pharmaceutical agents may be used by optometrists pursuant to this paragraph.(C) An individual licensed to practice optometry pursuant to this chapter may use diagnostic and therapeutic agents only if certified to do so by the Board of Optometry in accordance with the provisions of § 3-1202.07.(D) Nothing in this paragraph shall be construed to authorize an individual licensed to practice optometry to use surgical lasers; to perform any surgery including cataract surgery or cryosurgery; or to perform radial keratotomy. For the purpose of this subparagraph, the term "surgery" shall not include punctal plugs, superficial foreign body removal, epilation, or dialation and irrigation.(E) An individual licensed to practice optometry may administer or prescribe the following drugs:(i) Antibiotics, but not oral systemic antiviral or antifungal agents;(iv) Non-steroidal anti-inflammatories;(iv) Medication for the initiation of immediate emergency treatment of angle closure glaucoma; and(v) Injectable systemic drugs to counter anaphylactic reactions.(F) Prior to initiating treatment for glaucoma, an optometrist shall consult with the patient's physician or other appropriate physician. The treatment of angle closure glaucoma by an optometrist shall be limited to the initiation of immediate emergency treatment.(G) Nothing in this paragraph shall be construed as preventing or restricting the practice, services, or activities of a licensed physician or as prohibiting an optician from providing eyeglasses or lenses on the prescription of a licensed physician or optometrist or a dealer from selling eyeglasses or lenses; provided, that the optician or dealer does not represent by title or description of services that he or she is an optometrist.(10A)(A) "Practice of pharmaceutical detailing" means the practice by a representative of a pharmaceutical manufacturer or labeler of communicating in person or through interactive virtual communication with a licensed health professional, or an employee or representative of a licensed health professional, located in the District of Columbia, for the purposes of selling, providing information about, or in any way promoting a pharmaceutical product.(B) For the purposes of this paragraph, the term:(i) "Labeler" means an entity or person that receives pharmaceutical products from a manufacturer or wholesaler and repackages them for later retail sale and that has a labeler code from the federal Food and Drug Administration under 21 C.F.R. § 207.20.(ii) "Manufacturer" means a maker of pharmaceutical products and includes a subsidiary or affiliate of a manufacturer.(iii) "Pharmaceutical product" means a drug or biologic for human use regulated by the federal Food and Drug Administration.(11)(A) "Practice of pharmacy" means the interpretation and evaluation of prescription orders; the dispensing and labeling of drugs, devices, and biologicals; the compounding of drugs as authorized by federal and District law; the prescribing and dispensing of self-administered hormonal contraceptives when certified by the Board of Pharmacy to do so and in accordance with regulations issued by the Mayor; drug and device selection; responsibility for advising and providing information, where regulated or otherwise necessary, concerning drugs, devices, and biologicals, and their therapeutic values, content, hazards, and uses in the treatment and prevention of disease; responsibility for conducting drug-regimen reviews; responsibility for the proper and safe storage and distribution of drugs, devices, and biologicals; the administration of a prescribed drug, device, and biological in accordance with regulations issued by the Mayor; the order and administration of immunizations and vaccinations in accordance with the Centers for Disease Control and Prevention's published guidelines and recommended immunization schedules for adults aged 18 and older with valid identification, adolescents and children aged 3 through 17 with written informed parental consent or without consent if authorized by District law, and the administration of immunizations and vaccinations to any individual pursuant to a valid prescription when certified by the Board of Pharmacy to do so; conducting health screenings, including ordering, performing, and interpreting Clinical Laboratory Improvement Amendments-waived tests; the offering or performance of those acts, services, operations, and transactions necessary in the conduct, operation, management, and control of a pharmacy; the initiating, modifying, or discontinuing a drug therapy in accordance with a duly executed collaborative practice agreement; the maintenance of proper records; and a range of professional healthcare and clinical services as determined by the Mayor through rulemaking, but including: (i) Medication Therapy Management;(ii) Management of chronic conditions, including Type 2 diabetes mellitus and hypertension;(iii) Performing foot checks for patients with diabetes;(iv) Performing point-of-care testing for blood glucose;(v) Providing diabetes education;(vi) Performing point-of-care testing and cholesterol monitoring;(vii) Offering tobacco-cessation services;(viii) Providing transition-of-care services;(ix) Administering anticoagulation therapy;(x) Screening for depression and other mental health conditions;(xi) Conducting asthma Control checks;(xii) Screening for sexually transmitted diseases; and(xiii) Extending prescriptions as medically necessary, excluding controlled substances or specialized medications; and(xiv) Initiation of Pre Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis (PEP) for the prevention of HIV/AIDS pursuant to a protocol.(B) For the purposes of this paragraph, the term: (i) "Administration" means the direct application of a prescription drug, device, or biological to the body of the patient by injection, inhalation, ingestion, or other means.(ii) "Collaborative practice agreement" means a voluntary written agreement between a licensed pharmacist and a licensed physician that has been approved by the Board of Pharmacy and the Board of Medicine, either directly or through rulemaking, or between a licensed pharmacist and another health practitioner with independent prescriptive authority licensed by a District health occupation board, that defines the scope of practice between the licensed pharmacist and licensed physician, or other health practitioner, for the initiation, modification, or discontinuation of a drug therapy regimen.(iii) "Pharmacy" means an establishment or institution, or any part thereof, where the practice of pharmacy is conducted, drugs are compounded or dispensed, offered for sale, given away, or displayed for sale at retail, or prescriptions are compounded or dispensed.(iv) "Prescription" means an order for a drug, medicinal chemical, biological, or combination or mixtures thereof, or for a medically prescribed medical device, in writing, or on an approved electronic form, dated and signed by an authorized health professional, or given orally to a pharmacist by an authorized health professional or the person's authorized agent and immediately reduced to writing by the pharmacist or pharmacy intern.(C) The Mayor shall establish regulations to ensure the safe and effective provision of the services listed under subparagraph (A) of this paragraph, including appropriate training requirements and protocols for collaboration with other healthcare professionals.(12)(A) Practice of physical therapy" means the independent evaluation or treatment of human disability, injury, or disease through the specific scientific application of physical measures to secure the functional rehabilitation of the human body; utilizing standard procedures of physical therapy to treat patients with mechanical, physiological, and developmental impairments, functional limitations, and disabilities, or other health and movement-related conditions to alleviate the effects of these conditions, to reduce the risk of injury, and to promote and maintain fitness, health, and wellness in populations of all ages; the ability to order imaging as part of the evaluation process; and the teaching and researching of physical therapy.(B) "Practice by physical therapist assistants" means the performance of selected components of a physical therapy treatment intervention by a person who has graduated from a physical therapist assistant program accredited by an agency recognized for that purpose by the Secretary of the Department of Education or the Council of Postsecondary Accreditation and is licensed pursuant to this act to assist a physical therapist.(C) Nothing in this paragraph shall be construed as preventing or restricting the practices, services, or activities of a physical therapy aide who works only under the direct supervision of a physical therapist, and whose activities do not require advanced training in, or complex application of, therapeutic procedures or other standard procedures involved in the practice of physical therapy.(13) "Practice by physician assistants" means the performance, in collaboration with a licensed physician or osteopath, of acts of medical diagnosis and treatment, prescription, preventive health care, and other functions which are authorized by the Board of Medicine pursuant to § 3-1202.03.(13A) "Practice by physicians-in-training" means the practice of medicine by a medical resident or fellow, or other similar designation, enrolled in a nationally accredited training program or a training program in the District that is approved by the District of Columbia Board of Medicine.(14) "Practice of podiatry" means the diagnosis, treatment, prevention, and care of pathology and ailments of all structures and tissues of the human foot and ankle, the anatomical structures that attach to the human food, ankle, and soft tissue at or below the knee, by surgical, medical, or mechanical means, with or without compensation. A licensed podiatrist may administer local anesthesia, as well as injections, immunizations, and vaccinations.(14A)(A) "Practice of polysomnography" means the process of analyzing, monitoring, and recording physiologic data during sleep and wakefulness, with or without compensation, to assist in the assessment and diagnosis of sleep-wake disorders and other disorders, syndromes, and dysfunctions that are sleep-related, manifest during sleep, or that disrupt normal sleep-wake cycles and activities.(B) For the purposes of this paragraph, the term: (i) "Polysomnographic technician" means a person who is registered with the Board of Medicine and is authorized to perform certain polysomnography procedures as determined by the Board while generally supervised by either a physician who is licensed in the District of Columbia or a polysomnographic technologist who is licensed by the District of Columbia who is on-site or available through voice communication.(ii) "Polysomnographic technologist" means a person who is licensed with the Board of Medicine and is authorized to practice polysomnography; provided, that a polysomnographic technologist shall practice under the general supervision of a physician who is licensed in the District of Columbia.(iii) "Polysomnographic trainee" means a person who is registered with the Board of Medicine and authorized to perform basic polysomnography procedures, as determined by the Board, while directly supervised by a physician who is licensed in the District of Columbia, a polysomnographic technologist who is licensed in the District of Columbia, or a polysomnographic technician who is registered in the District of Columbia and on the premises and immediately available for consultation.(C) Nothing in this paragraph shall be construed as limiting a qualified licensed respiratory care practitioner or licensed physician in his or her scope of practice, including care in connection with the provision of polysomnography services.(15) "Practice of practical nursing" means the performance, under the supervision of a registered nurse, advanced practice registered nurse, licensed physician, or other authorized health care provider, with or without compensation, of directed nursing services required in observing and caring for sick, injured, convalescent, or disabled patients, in promoting preventive measures in community health, in acting to safeguard life and health, in administering treatment and medication prescribed by a physician, dentist, or advanced practice registered nurses, or in performing other acts not requiring the skill, judgment, and knowledge of a registered nurse. The practice of practical nursing includes the training of nursing assistive personnel and shall be subject to the nursing standards established or recognized by the Board of Nursing in accordance with regulations promulgated by the Mayor.(15A) "Practice of professional art therapy" means the integrative application of psychotherapeutic principles and methods with specialized training in art media, the neurobiological implications of art-making, and art-based assessment models to assist an individual or group to improve cognitive and sensory-motor functions, increase self-awareness and self-esteem, cope with grief and traumatic experience, resolve conflicts and distress, and enhance social functioning. The practice of professional art therapy includes: (A) Therapeutic interventions to facilitate alternative modes of receptive and expressive communication, which can circumvent the limitations of verbal articulation; and(B) Evaluation and assessment to define and implement art-based treatment plans to address developmental, behavioral, cognitive, and emotional needs.(15B) "Practice of professional counseling" means engaging in counseling or psychotherapy activities, including cognitive behavioral therapy or other modality, with or without compensation, to facilitate human development and to identify and remediate mental, emotional, or behavioral conditions and associated difficulties that interfere with mental health and wellness. The practice of professional counseling includes: (A) The processes of conducting interviews, tests, and other forms of assessment for the purpose of diagnosing individuals, families, and groups, as outlined in the Diagnostic and Statistical Manual of Disorders or other appropriate classification schemes, and determining treatment goals and objectives;(B) Assisting individuals, families, and groups through a professional relationship to achieve long-term effective mental, emotional, physical, spiritual, social, educational, or career development and adjustment;(C) Determining and evaluating treatment goals and objectives and implementing counseling techniques and evidence-based counseling methods, models, and interventions to achieve treatment plan goals; and(D) Teaching and supervising the practice of professional counseling.(16)(A) "Practice of psychology" means the observation, description, evaluation, interpretation, prediction, and modification of human behavior by the application of psychological principles, methods, and procedures, with or without compensation, for the purposes of: (i) Preventing, eliminating, assessing, or predicting symptomatic, maladaptive, or undesired behavior;(ii) Evaluating, assessing, or facilitating the enhancement of individual, group, or organizational effectiveness, including personal effectiveness, adaptive behavior, interpersonal relationships, work and life adjustment, health, and individual, group, or organizational performance; or(iii) Providing effective services to help children and youth succeed academically, socially, behaviorally, and emotionally and direct educational and mental health services for children and youth, including working with parents, educators, and other professionals to create supportive learning and social environments for children.(B) Limitations on the authorization to practice psychology under this paragraph shall be set forth as follows: (i) A person licensed as a health services psychologist is authorized to practice psychology within the full scope of subparagraph (A) of this paragraph;(ii) A person licensed as a general applied psychologist is authorized to practice psychology within the scope of subparagraph (A)(ii) of this paragraph;(iii) A person registered as a school psychologist is authorized to practice psychology within the scope of subparagraph (A)(iii) of this paragraph; and(iv) A person registered as a psychology associate is authorized to practice psychology within the scope of subparagraph (A)(i) of this paragraph; provided, that they practice only under the supervision of a licensed health services psychologist.(C) Nothing in this paragraph shall be construed as preventing or restricting the practice, services, or activities of:(i) An individual bearing the title of psychologist in the employ of an academic institution, research organization, or laboratory, if the psychology-based activities or services offered are within the scope of employment, are consistent with his or her professional training and experience, and are provided within the confines of employment; or(ii) A school psychologist employed by District of Columbia Public Schools or a public charter school and working in accordance with regulations issued by the Office of the State Superintendent of Education.(16A) "Practice of recreational therapy" means the systematic process that utilizes recreation and other activity-based interventions to address the assessed needs of individuals with illness or disabling conditions as a means of psychological and physical health, recovery, and well-being, including treatment services designed to restore, remediate, and rehabilitate a person's level of functioning and independence in life activities, to promote health and wellness and reduce, or to eliminate the activity limitations and restrictions to participate in life situations caused by illness or a disabling condition.(17) "Practice of registered nursing" means the performance of the full scope of nursing services, with or without compensation, designed to promote, protect, optimize, and maintain health and abilities, prevent illness and injury, facilitate healing, alleviate suffering through the diagnosis and treatment of human response, and advocate for the care of individuals, families, groups, communities, and populations. The practice of registered nursing includes the performance of acts requiring substantial specialized knowledge, judgment, and skill based on the principles of the biological, physiological, behavioral, and sociological sciences, including administrative, educational, and research functions, and shall be subject to standards established or recognized by the Board of Nursing and in accordance with regulations promulgated by the Mayor.(17A) "Practice of respiratory care" means the diagnostic evaluation, assessment, care and treatment, management, or rehabilitation, in collaboration with a licensed physician, of patients who have deficiencies and abnormalities which affect the pulmonary system and associated aspects of the cardiopulmonary or other systems.(18)(A) "Practice of social work" means the application of social work theory, knowledge, methods, ethics, and the professional use of self to restore or enhance social, psychosocial, or biopsychosocial functioning of individuals, couples, families, groups, organizations, and communities, which may include, depending on an individual's level of social work licensure and area of practice, the formulation of psychosocial evaluation and assessment, counseling, psychotherapy, referral, advocacy, mediation, consultation, research, administration, education, and community organization.(B) Nothing in this paragraph shall be construed to authorize any person licensed as a social worker under this chapter to engage in the practice of medicine.(19)(A) "Practice of speech-language pathology" means the application of principles, methods, or procedures related to the development and disorders of human communication, including any condition, whether of organic or non-organic origin, that impedes the normal process of human communication including disorders and related disorders of speech, articulation, fluency, voice, oral, or written language; auditory comprehension and processing; oral, pharyngeal or laryngeal sensorimotor competencies; swallowing; auditory or visual processing; auditory or visual memory or cognition; communication; and assisted augmentative communication treatment and devices.(B) The term practice of speech-language pathology also includes the planning, directing, supervising, and conducting of a habilitative and rehabilitative counseling program for individuals or groups of individuals who have, or are suspected of having, disorders of communication, and any service in speech-language pathology including prevention, identification, evaluation, consultation, habilitation or rehabilitation, instruction, or research.(C) The practice of speech-language pathology may include pure-tone air conduction hearing screening, screening tympanometry, and acoustic reflex screening, limited to a pass-or-fail determination for the identification of individuals with other disorders of communication and may also include aural habilitation or rehabilitation, which means the provision of services and procedures for facilitating adequate auditory, speech, and language skills in individuals with hearing impairment. The practice of speech-language pathology does not include the practice of medicine or osteopathic medicine, or the performance of a task in the normal practice of medicine or osteopathic medicine by a person to whom the task is delegated by a licensed physician.(19A) "Practice by a speech-language pathology assistant" means assisting a licensed speech-language pathologist in implementing speech-language pathology care and treatment plans for patients under the supervision and direction of the licensed speech-language pathologist.(19B) "Practice by a speech-language pathology clinical fellow" means the practice of speech-language pathology by a participant in a clinical fellowship that meets the definition set forth in § 3-1209.11.(20) "Practice by surgical assistants" means the provision of aid by a person who is not a physician licensed to practice medicine, under the direct supervision of a surgeon licensed in the District of Columbia, in exposure, hemostasis, closures, and other intraoperative technical functions that assist a physician in performing a safe operation with optimal results for the patient.(21) "Practice by trauma technologists" means the provision of emergency medical care to trauma patients in a Level 1 trauma facility as designated by the Director of the Department of Health pursuant to Chapters 27 and 28 of Subtitle B of Title 22 of the District of Columbia Municipal Regulations (22-B DCMR § 2700 et seq. and § 2800 et seq.), under either the direct or indirect supervision of a physician licensed to practice medicine in the District of Columbia.(22) "Practice of veterinary medicine" means:(A) The diagnosis, prognosis, prevention, testing, or treatment of a disease, pain, deformity, defect, injury, or any other physical condition of an animal;(B) Performing a surgical, medical, or dental procedure, or rendering surgical, medical, or dental aid to, for, or upon an animal;(C) The practice of another branch or specialty of medicine or health care on an animal; or(D) Prescribing, administering, or dispensing of drugs or medications for use on animals or for euthanasia of an animal.Amended by D.C. Law 25-191,§ I-101, 71 DCR 006698, eff. 7/19/2024.Amended by D.C. Law 24-302, § 2 , 70 DCR 000583, eff. 3/10/2023.Amended by D.C. Law 24-46, § 2 , 69 DCR 000177, eff. 12/29/2021.Amended by D.C. Law 23-251, § III-301 , 68 DCR 003673, eff. 3/16/2021.Amended by D.C. Law 23-115, § 2 , 67 DCR 5077, eff. 6/24/2020.Amended by D.C. Law 23-97, § 2 , 67 DCR 3912, eff. 6/17/2020.Mar. 25, 1986, D.C. Law 6-99, § 102, 33 DCR 729; July 22, 1992, D.C. Law 9-126, § 2(b), 39 DCR 3824; Mar. 14, 1995, D.C. Law 10-203, § 2(b), 41 DCR 7707; Mar. 14, 1995, D.C. Law 10-205, § 2(a), 41 DCR 7712; Mar. 21, 1995, D.C. Law 10-231, § 2(b), 42 DCR 15; Mar. 23, 1995, D.C. Law 10-247, § 2(b), 42 DCR 457; Apr. 18, 1996, D.C. Law 11-110, § 7(a), 43 DCR 530; July 24, 1998, D.C. Law 12-139, § 2(a), 45 DCR 2975; Mar. 10, 2004, D.C. Law 15-88, § 2(c), 50 DCR 10999; July 8, 2004, D.C. Law 15-172, § 2(b), 51 DCR 4938; Mar. 16, 2005, D.C. Law 15-237, § 2(b), 51 DCR 10593; Mar. 6, 2007, D.C. Law 16-219, §2(c), 53 DCR 10211; Mar. 6, 2007, D.C. Law 16-220, § 2(a), 53 DCR 10216; Mar. 6, 2007, D.C. Law 16-221, § 2, 53 DCR 10218; Mar. 6, 2007, D.C. Law 16-228, § 2(b), 53 DCR 10244; Mar. 26, 2008, D.C. Law 17-131, § 102(b), 55 DCR 1659; Mar. 20, 2009, D.C. Law 17-306, § 2(a), 56 DCR 23; Mar. 25, 2009, D.C. Law 17-353, §§ 146(a), 147, 148, 309(a), 56 DCR 1117; July 7, 2009, D.C. Law 18-11, § 2(a), 56 DCR 3602; July 7, 2009, D.C. Law 18-12, § 2(a), 56 DCR 3605; July 7, 2009, D.C. Law 18-13, § 2(b), 56 DCR 3608; July 7, 2009, D.C. Law 18-14, § 2(b), 56 DCR 3613; July 7, 2009, D.C. Law 18-15, § 2(c), 56 DCR 3616; July 7, 2009, D.C. Law 18-16, § 2, 56 DCR 3620; July 7, 2009, D.C. Law 18-17, § 2(a), 56 DCR 3622; July 7, 2009, D.C. Law 18-18, § 2(b), 56 DCR 3624; July 7, 2009, D.C. Law 18-19, § 2(b), 56 DCR 3629; Mar. 14, 2012, D.C. Law 19-104, § 2(a), 59 DCR 435; Oct. 22, 2012, D.C. Law 19-185, § 2(a), 59 DCR 9454; Jan. 25, 2014, D.C. Law 20-64, § 2(b), 60 DCR 16533; Mar. 26, 2014, D.C. Law 20-96, § 102(c), 61 DCR 1184; May 2, 2015, D.C. Law 20-272, § 2(b), 62 DCR 1911; Mar. 9, 2016, D.C. Law 21-77, § 3(a), 63 DCR 756; Mar. 28, 2018, D.C. Law 22-75, § 2(b), 65 DCR 1374; Apr. 11, 2019, D.C. Law 22-300, § 2(a), 66 DCR 2024.