Peggy kindly typed this summary of our recent meeting. I will try to post the complete proposed revisions of the regs under COMMENTS, but it may be too large.
Update: We met with Rep. Mizuno on Monday, July 7, for an informational briefing. The DOH, the CDC and numerous other entities were present. Tricia, Sean, Conor and myself came loaded for bear, but to our pleasant surprise the DOH admitted they had not revised the test or the guidelines for over 17 years (the test has been 27 years). With their admission, our prepared arguments were rather moot. Tricia and Sean did speak eloquently before the group about the need for revisions & updates, and for the addition of body piercing regulations .
Dr. Tice with the CDC spoke first and his honest approach set the stage for open discussions. Larry Lau from the DOH spoke of educating the public about safe and non-safe tattooing. We had brought in visual aids of of sterilized good, clean technique set up, and proper barrier protection, as well as tools--both modern and traditional. I think the DOH, CDC, and the press were duly impressed!
Overall we came away with a huge sigh of relief at how smooth it all went. We are not letting our guard down, but it sure wasn't the battle we had anticipated. The media coverage was also amazing. See http://starbulletin.com/2008/07/08/news/story10.html and http://www.honoluluadvertiser.com/apps/pbcs.dll/article?AID=/20080708/NEWS01/807080336/1001/LOCALNEWSFRONT
The DOH and CDC are working together now to revamp the regs and the test. Hopefully they will continue to work with us and accept our input. We'll keep you all posted of new developments. We owe huge thanks to Heather Lusk and Representative Mizuno, who both seem 100% committed to seeing this through.
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PROPOSED TATTOO STATUTES AND REGULATIONS
Definitions. As used in these rules:
“Department” means the department of health of the State of Hawaii.
“Director” means the director of the department of health or a duly authorized agent or representative.
“License” means a license issued to a tattoo artist under this chapter.
“Permit” means a permit issued to a tattoo shop under this chapter.
“Tattoo Artist” and/or “Tattooist” means anyone causing a permanent or semi-permanent marking by insertion of a pigment into the skin by any means, be it electric machine or hand tools.
11-17-3 Permit for tattoo shop
(a) No person, partnership, firm or corporation shall operate a tattoo shop unless such person, partnership, firm or corporation has registered such shop with the department and has been issued a permit. No permit shall be issued or renewed unless the shop has been inspected by the director and found to be in compliance with the requirements of this chapter.
(b) The permit shall be non-transferable. A valid permit shall be posted in a conspicuous place in every tattoo shop
(c) Each initial application under this section shall be accompanied by a fee of $125 for a permit valid for one year. For a renewal, each applicant shall pay a fee of $75 per year. Initial permit fees and renewal fees may be increased a maximum of $10 per year.
(d) In the event of withdrawal of an application or failure to qualify for a permit, the fee shall not be refunded to the applicant.
(e) All permits shall expire on January 31 of each year. Application for the renewal of a permit shall be submitted to the department in writing before January 10 of each year.
(f) Temporary permits will be given for tattooing to occur in locations other than a permitted tattoo studio, for the purpose of trade shows and educational demonstrations, only if the facility and operational plan meet all standards set by professional tattoo associations for convention safety following OSHA (Standards 29 CFR 1910.1030) and/or HIOSH (Title 12, Part 8, Chapter 205.2), as well as the specifications in 11-17-6. Application must be made in writing to the department at least 60 days prior to the scheduled event, and must include specific measures that will be taken to meet specified health and safety standards, as well as a $25 application fee. Permit fees and further requirements are as follows:
(1) Should the event involve the participation of three or more tattooists, a site inspection must occur, and upon approval, a fee of $250 must be paid prior to the granting of the temporary permit.
(2) Should the event involve fewer than three tattooists, no site inspection is necessary and a fee of $50 must be paid prior to the granting of the temporary permit.
(3) Fees may be increased by a maximum of $20 and $50 respectively per year.
(g) Penalty for tattooing at a location without a permit shall be a fine of no less than $500 and no more than $5000.
11-17-4 License for tattoo artist.
(a) No person shall practice the art of tattoo either gratuitously or for pay unless the person holds a valid tattoo license issued by the department. A physician licensed to practice in the state of Hawaii is exempt from this chapter.
(b) Any person desiring to engage in tattooing shall apply in writing to the director on the form provided by the department for this purpose. Any applicant who has not previously been issued a license by the director shall be required to pass a up-to-date written examination on virology, bacteriology and aseptic techniques before a license may be issued. Official proof of passing a bloodborne pathogen course developed specifically for the tattoo industry, such as the Alliance of Professional Tattooist course, Prevention of Disease Transmission in Tattooing, within the last two years is acceptable in lieu of the Hawaii State tattoo exam.
(c) Each applicant shall pay a fee of $125 for the initial exam. Renewals will be required on even numbered years, and shall be accompanied by a renewal fee of $75. Exam fees may be increased by a maximum of $25 per year and renewal fees may each be increased a maximum of $10 per year.
(d) Temporary licenses will be granted to visiting tattoo artists for a maximum of fourteen (14) days in any given calendar year provided they meet one of the following:
(1) the tattoo artist must show official proof of passing a bloodborne pathogen course developed specifically for the tattoo industry, such as the Alliance of Professional Tattooist course Prevention of Disease Transmission in Tattooing within the last two years; or
(2) the tattoo artist must show official proof of passing an OSHA approved course on bloodborne pathogens within the last two years, or
(3) the tattoo artist must have passed the Hawaii Department of Health tattoo artist written exam within the last two years.
(e) Application for temporary tattoo licenses must be made in writing to the department at least 60 days prior to the proposed work dates, and must be accompanied by an application fee of $25, in addition to proof of meeting the aforementioned course/test requirements. The tattoo artist will be notified by mail of the approval or denial of their application. Should the temporary license be granted, the letter of notification and a photo ID must be shown, and a temporary license fee of $100 must be paid when picking up their license upon the onset of work dates. Temporary licensing fees may be increased by a maximum of $10 per year.
(f) In the event the applicant fails to qualify for a license or for renewal, the fees will not be refunded to the applicant.
(g) No license (temporary or otherwise) or renewals will be granted until the applicant has met the following health requirements:
(1) the applicant must show proof of a negative TB test taken within the past six months, and
(2) the applicant must show proof of receiving the complete Hepatitis B vaccination series, or antibody testing showing immunity, unless the vaccine is contraindicated for medical reasons, as specified in OSHA Bloodborne Pathogens Standard 1910.1030(f).
(h) Penalties for tattooing without proper licensing shall be a fine of no less than $500 and no more than $5000.
11-17-5 Revocation or suspension of license or permit.
(a) After due notice and hearing the director may suspend or revoke any license or permit issued under this chapter for violation of the provisions of this chapter when:
(1) The person is found guilty of any fraud, deceit or misconduct in the practice of the occupation of tattooing.
(2) Violates any rules adopted by the department.
(b) All revocation and suspension action shall not become effective nor final until an opportunity for a hearing has been offered the license or permit holder. All hearings shall comply with Chapter 91, HRS and the department of health rules of practice and procedures.
11-17-6 Sanitation requirements for a tattoo studio. A tattoo studio shall comply with the following requirements in order to qualify for an operating permit:
(a) The shop shall be maintained in a sanitary condition by the owner or operator.
(b) The owner or operator of a tattoo studio shall locate the shop in areas least subjected to dust contamination. Filters on air conditioners should be cleaned and replaced on a regular basis.
(c) Adequate ventilation and lighting shall be provided. Any switches or light fixtures adjusted during the tattoo procedure must be covered with a waterproof barrier, which is changed after each client.
(d) The walls and ceilings shall be easily cleanable, smooth and light colored. All walls shall be kept clean and in good repair.
(e) All floors shall be of smooth, non-absorbent materials and constructed as to be easily cleanable. All floors shall be kept in good repair and cleaned with an appropriate solution such as diluted bleach on a regular basis. No carpeting whatsoever may be in the vicinity of the tattooing area.
(f) All counter tops and/or table tops where tattooing will take place must be stainless steel or a non-porous light colored surface which can be wiped clean with an antimicrobial solvent, such as D-limonene, Sporicidin, or diluted bleach.
(g) All chairs, massage tables and furniture in the work area must be of vinyl or a similar material that can be wiped clean with a antimicrobial solution such as D-limonene, Sporicidin, or diluted bleach. The chair or massage table where the recipient is to receive the tattoo must also be covered with a disposable waterproof barrier to be removed and disposed of immediately after completion of the tattoo. Plastic wrap or disposable bed pads are satisfactory.
(h) The work stations shall be located at least 8 feet from observers and waiting customers or shall be separated with a panel of glass, plastic or other similar material at least six feet high. No visitors will be allowed in the tattoo work area.
(i) The tattoo studio shall have covered waste receptacles that meet OSHA standards.
(j) Each work station shall be provided with an OSHA approved SHARPS receptacle for proper needle disposal.
(k) Each tattoo studio shall include a sink for the exclusive use of the tattoo artist for hand washing and preparing the customer for tattooing. The sink shall have adequate hot and cold running water under pressure with mixing valve or combination faucet. There shall be available at the sink antibacterial soap, clean single use towels and refuse containers.
(l) Water closet and hand basin shall be available on the premises for use by customers and tattoo artists. The plumbing fixtures and toilet room shall be maintained in a sanitary condition and in good repair.
(m) A copy of the OSHA Bloodborne Pathogen Standards and Exposure Control must be readily available in the tattoo studio and accessible to all employees and tattooists. All employees must be familiar with OSHA specified procedures which must be followed at all times.
11-17-7 Restrictions.
(a) It shall be unlawful to tattoo any person who is under the influence of intoxicating substances. These substances include but shall not be limited to alcohol, drugs, or other intoxicating substances.
(b) It shall be unlawful to tattoo any person under the age of 18 without written consent of the parents or legal guardian. All written consent shall be kept confidentially on file in the tattoo studio for a minimum of 2 years.
(c) It shall be unlawful to tattoo anyone under the age of 16 regardless of parental or legal guardian consent.
(d) No person with a communicable disease which may be transmitted despite
universal precautions may practice tattooing while actively infectious. The director may require a formal letter or certificate signed by a duly licensed physician stating that the tattoo artist's health is not a risk to clients or fellow employees before returning to work.
(e) All clients shall complete a state approved consent form, to kept confidential in the tattoo studio for two years, which shall include the following:
(1) part I to be completed by the tattooist or shop employee shall include:
(a) Date of tattoo application
(b) Name, address, date of birth and signature of client
(c) Design and location of tattoo
(d) Name of tattoo artist
(2) Part II to be completed by the client shall include:
(a) Known allergies, medications, and health issues including possible disease which may be a hindrance to the application or healing process.
(b) Acknowledgement by the client of the tattoo procedure.
(c) The date and signature of the client, in permanent ink.
11-17-8 Equipment.
(a) Sterilization shall be by autoclave or by immersion in CDC/OSHA approved liquid sterilants.
(1) Autoclaves must be inspected regularly, and all gaskets and seals must be in good condition.
(2) Autoclaves must be spore tested every 60 days with results logged and/or certification kept and available for inspection for a period of 2
years.
(b) Pre-sterilized needles and disposable tubes must display an expiration
date on packaging.
11-17-9 Dyes. All dyes or pigments used in tattooing must be approved under chapter 328, HRS.
11-17-10 Aseptic Technique.
(a) Before working on a client the tattoo artist shall cleanse their hands in the following manner:
(1) Thoroughly wash hands, fingernails, wrists and forearms with antibacterial soap. Inspect for small cuts and abrasions.
(2) Rinse hands under warm running water.
(3) Dry hands with clean, single use towels or other approved drying device.
(4) After washing, any and all wounds on the hands or arms of the tattooist must be covered with waterproof or bioclusive dressings. Should the location prohibit such coverings the tattoo artist may not proceed, and may only resume tattooing when such wounds and abrasions have healed.
(b) The area of the customer’s skin to be tattooed shall be prepared in the following manner:
(1) Wiping the area with seventy percent alcohol
(2) Disinfecting the site with a germicidal solution.
(3) Shave with single use, disposable razor.
(c) The stencil for transferring the design shall be single use only. Markers used to illustrate on the skin shall be single use only.
(d) Single service individual portions of dyes or pigments in single service containers shall be used for each person. After the tattoo the remaining unused dye or pigment and single service container shall be discarded.
(e) The completed tattoo shall be washed with a clean disposable material saturated with a germicidal solution. The site will be covered with an absorbent bandage fastened to the site with medical tape (plastic wrap is not to be used as a bandage material). Gloves must be worn during the washing and bandaging process.
(f) Upon completion of the tattoo the tattoo artist shall advise the customer of the care of the tattoo both verbally and in writing. The tattoo artist must provide the customer with their studio name and phone number on the aftercare instructions. The tattoo artists must advise the customer to consult a physician at the first sign of infection.
11-17-11 Operating standards. All operations must include but are not limited to the requirements specified herein.
(a) The tattoo artist shall use standards of aseptic technique in tattooing, dressing and other operations that are approved by the director.
(b) The tattoo artist and employees shall follow all safety regulations specified by OSHA regulations 29CFR 1910.1030 Bloodborne Pathogens Standard and Exposure Control.
11-17-12 Penalty.
(a) Any person who shall knowingly or willfully make any false statement to the department relative to any matter under this chapter shall be guilty of a misdemeanor and upon conviction shall be punished by a fine not less than $500 nor more than $5000 for each offense.
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