2024, published by the National Environmental Health Association (NEHA).
Body Art Model Code Adoption Toolkit April 2024
NATIONAL ENVIRONMENTAL HEALTH ASSOCIATION 720 S. Colorado Blvd., Ste. 105A Denver, CO 80246
Body Art Model Code Adoption Guide
Contents
Before Adoption .................................................................................................................................................................................. 4 Getting Ready.................................................................................................................................................................................. 4 Explain the Why ............................................................................................................................................................................. 5 Collaborate with Partners ........................................................................................................................................................... 6 Learn from your Peers................................................................................................................................................................... 7 Gather Support................................................................................................................................................................................ 8 Adoption ................................................................................................................................................................................................ 9 Propose the Changes .................................................................................................................................................................... 9 Attend and Host Public Meetings ............................................................................................................................................. 9 After Adoption ................................................................................................................................................................................... 10 Provide Support ............................................................................................................................................................................ 10
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Body Art Model Code Adoption Guide
The Body Art Model Code is the only comprehensive model code that addresses current body art issues and public health risks. We update it in partnership with public health and industry experts every five years to ensure it remains relevant and scientifically defensible. Many state, local, tribal, and territorial (SLTT) public health agencies across the U.S. are responsible for regulating body art. Developing and adopting body art regulations can be a long and challenging process that can vary widely between jurisdictions due to differing administrative procedures and rulemaking processes. This model code provides uniform guidance for those agencies. The BAMC is neither federal law nor regulation. Jurisdictions can choose to adopt it by reference (in its entirety) or by specific section (not in its entirety), meaning specific sections are adopted from the BAMC whereas other sections are not. A single adoption process across jurisdictions isn’t possible due to varying administrative procedures and rulemaking processes. This toolkit outlines a path to Body Art Model Code (BAMC) adoption and provides relevant resources at each step.
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Body Art Model Code Adoption Guide
Before Adoption Getting Ready
Before you begin the journey to creating or updating body art regulations in your jurisdictions, it is important to understand your jurisdiction's current BAMC adoption status and the administrative and rulemaking processes you will navigate as you work to adopt new body art regulations. Use the steps and resources below to plan for BAMC adoption in your jurisdiction. Identify current body art legislation and regulations in place in your jurisdiction. • U.S. State Regulatory Information – (SPCP.ORG) • Alliance of Professional Tattooist’s Body Art Regulation Support System (BARSS – Discord) • Regulations and Legislation – Association of Professional Piercers (safepiercing.org) • 2023 State Legislation on Body Art (neha.org) Understand the differences between your current code and the code you wish to adopt. • Research existing laws that pertain to body art regulation in your jurisdiction. • Review the NEHA Body Art Model Code and Annex Create an adoption team. Partner with internal staff and external partners to support the process. Internal team members can help: • Develop an update timeline • Review existing procedures and regulations • Navigate the administrative and rule-making process • Provide communication and messaging support External partners can: • Advocate for adoption of updated regulations • Write letters of support • Provide testimony • Work with your team to identify potential barriers or concerns with implementing the BAMC • Help to resolve issues, concerns, or barriers
The team can also help to start communicating with impacted communities early in the process and identify potential organizations, leaders, decision makers, and groups that are likely to support BAMC adoption.
Learn about local procedures for rulemaking. Work closely with your legislative or regulatory team to understand the process, requirements, and timelines to formulate, amend, and repeal rules. Discuss common issues that arise during this process and how you might work to resolve them.
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Body Art Model Code Adoption Guide
Explain the Why Decision makers will want to understand why it is important to update the jurisdiction’s body art regulations. You may need to provide written justification or be ready with talking points explaining why adopting body art regulations would be beneficial. Use these steps and resources to be ready to answer questions, share facts, and discuss the benefits of adoption. Gather background information. • Review the Background section on page 2 of the Body Art Model Code to answer questions about the document’s validity. • Hear from artists and regulators about why regulations and training are important to ensure safety for clients and practitioners, such as in our Why Body Art Facility Inspector Training video • Familiarize yourself with the risks associated with body art procedures. o Tattoos: Understand risks and precautions - Mayo Clinic o Tattoos & Permanent Makeup: Fact Sheet - FDA o Body Art Practitioners Guide – San Diego • Understand the evolution of body art regulation in the U.S. and the industry’s call for regulatory measures. o Explosion in Tattooing, Piercing Tests State Regulators - Stateline • Understand the role of environmental health professionals in ensuring safe body art practices and the need for additional support. o NEHA 2021 Body Art Needs Assessment Summary • Understand what is important to local industry. o Talking with Industry Understand the science. Review the Annex to the BAMC to understand the justification and scientific rationale to support the requirements of the BAMC. Arm yourself with facts and the ‘why’ behind specific regulations to support the adoption of specific provisions.
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Body Art Model Code Adoption Guide
Collaborate with Partners Collaborating with the community is an important part of successful adoption of any policy - including the BAMC . Use the steps and resources below to connect and build relationships to garner support, feedback, and buy-in with both internal and external partners, including:
• Boards of Health • Industry partners • Regulatory partners • Local public health officials • Community members • Legislators and decision makers
Get to know your local public health officials and answer their questions. Help public health officials, legislators, and Boards of Health understand why adoption of and compliance with body art regulations is important. • Use testimonials from jurisdictions that have adopted the code to highlight the impact of implementation. • Let them know that you are a subject matter expert on body art and are available to speak with them. • Summarize the primary reasons for updating regulations into concise and direct talking points. • Use the Talking with Legislators job aid to help you formulate and target your communications specifically for a legislative audience. • Provide a clear path forward that they can support. Identify allies among community members. Community members can be strong allies for BAMC adoption such as by providing testimony to decision makers. As a provider of a valuable public service, consider actively involving your community. Engage with local body artists. Body artists follow body art regulations and hence they are directly affected by their jurisdiction’s code. They can provide insight into the day-to-day impact of regulations and valuable parts of the code to adopt.
“
Regulations don’t just impact those who are doing the enforcement but also have a great impact on those in the industry. To have the most successful and impactful regulations you need to be cognizant of the viewpoints and experiences from both sides; regulators and industry.
- Katherine Martinez, REHS
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Body Art Model Code Adoption Guide
Learn from your Peers BAMC adoption has implications for many members of the community. Use the resources below to address concerns and questions during the adoption process. • Webinar: Body Art Blueprint: A Guide for Health Inspectors in Adopting Model Codes: Body art regulators talk about their experience adopting and utilizing the BAMC in their jurisdiction, including addressing major updates, advice on what worked, and lessons learned. • Annex to the BAMC: Use the Annex for explanation and further clarification on specific BAMC provisions. The Annex reflects the insights and expertise of the industry and regulatory experts wrote the BAMC. Below are examples of questions you may receive about certain sections of the Code. Be sure you’re able to answer the questions related to the code you’re working to adopt.
Section
Questions Addressed
2. Body Art Operator Requirements and Professional Standards 4. Specific Regulations for Specific Types of Body Art
Why are jewelry and artificial nails prohibited? Why is intact nail polish required?
Why can only distilled or sterile water be used for dilution of ink? Why is it important to use sterile gloves during a piercing procedure? Why is it important to use the process of “strike branding”? Why is an exposure control plan required? Why do you need operational records? Why do you need jewelry documentation? Why you need to store personnel Medical Records? Why should spore testing be conducted weekly for in-house sterilization? Are all-disposable facilities required to have an autoclave? Why is it important to register as a regulated waste generating facility? Why can't regulated waste storage exceed 30 days? Why are reusable barriers not allowed to be used? Why is a separate sterilization room required for reusable instruments? Why do all new facilities need to have access to a mop/utility sink?
6. Facility Documentation Requirements
8. Disinfection and Sterilization Procedures
11. Regulated Waste
12. Requirements for Premises
13. License Requirements
Why are artists and body art facilities both required to be licensed?
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Body Art Model Code Adoption Guide
Gather Support Showing decision makers the support you’ve received can help build the case for why adopting the BAMC is a worthwhile time and resource investment. Use the resources and tips below to gather support for BAMC adoption from regulatory programs, industry organizations, associations, and academia. Connect with industry organizations. Industry organizations can help jurisdictions get linked to resources, industry representatives, and direct technical assistance and guidance for BAMC adoption.
• Alliance of Professional Tattooists (APT) • Association of Professional Piercers (APP) • Society of Permanent Cosmetic Professionals (SPCP)
Share testimonials. Sharing testimonials from impacted community members during public meetings, hearings, and when talking to legislators can help provide real-world stories on the impact of regulations and the benefits of implementing the code. Gather letters of support. Collecting letters and statements of support from regulatory programs, industry organizations, associations, academia, and members of the community can be shared with decision makers to help justify BAMC adoption.
• Academia – Template Letter of Support • Associations - Template Letter of Support • Industry – Template Letter of Support • Regulatory – Template Letter of Support
Use policy statements as supplemental documents. • NEHA Policy Statement on Body Art • NEHA Policy Statement on Ear Piercing Guns (Expired 2021) • NEHA Policy Statement on Microblading (Expired 2021)
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Body Art Model Code Adoption Guide
Adoption Propose the Changes
When you are ready to officially present your proposal to decision makers such as a Board of Health, state legislature, or city, local, state, territorial, or tribal council(s), neatly package materials that include: • Background on body art and the need for adoption of BAMC • Detail of proposed changes • Supporting documents created or gathered • Justification and scientific rationale of the proposed regulations Attend and Host Public Meetings Depending on the jurisdiction’s administrative procedures, there will likely be one or more public meetings. Attend these meetings and continue to promote the BAMC adoption using supporting materials and your subject matter expertise. Hosting public meetings can also help bring community voices together and should be included throughout the lifecycle of code adoption. They can include meetings for industry about regulation decisions early in the process, or public comment periods on regulations before implementing. Below are resources about how to organize meetings, ensure engagement, and collect feedback. Conduct an effective public hearing. • Chapter 33. Conducting a Direct Action Campaign | Section 13. Conducting a Public Hearing | Main Section | Community Tool Box (ku.edu) • Follow ADA’s Effective Communication Requirements. Solicit public comments. To ensure the public comment period is successful, ensure it is advertised in relevant places and it is easy to submit comments and ask questions or clarification. Be sure to advertise the public comment periods on relevant platforms. • How It Works — Public Comment Project
It is important to have public hearings before making changes to your code. Reach out to regulators that would be impacted by his decision. Reach out to body artists to have separate discussions with them. Have conversation with the people who are impacted. - Katherine Martinez, REHS “
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Body Art Model Code Adoption Guide
After Adoption Provide Support
After the BAMC is adopted, regulatory staff, local industry, and the public will need to know about and/or be trained on the changes to body art in the jurisdiction. Use the steps and resources below to update the community. Develop an enforcement and compliance plan and timeline. • Seek support from the Alliance of Professional Tattooists (APT), the Association of Professional Piercers (APP), and the Society of Permanent Cosmetic Professionals (SPCP) on how to best partner with industry to attain compliance. • Include industry in the process of developing regulations and timelines together will make implementation straightforward and less stressful. Ensure they are notified when they’ll be expected to comply with updated regulations well in advance of the deadline. The current BAMC allows establishments and body artists operating at the time of the Code's enactment six months to comply with the updated regulations.
Create a training plan for regulatory staff and the local body art industry. • NEHA Body Art Facility Inspector Training • NEHA Body Art: Handling Sharps
Develop or update supplemental documents. • Modify our Plan Review Checklist to align with your jurisdiction’s regulations. When clicked, the checklist will download automatically. o Body Art Model Code Plan Review Checklist Inform the community. • Update the health department website with the adopted code and a summary of the primary changes to the code. • Ask artists what their preferred methods of communication are and use these channels. • Work with your communication staff to share details about the new regulations throughout the local community. • Provide, or ensure facilities have, informational handouts for their staff and the public. Be sure to include information on who to contact with any questions the public may have. o Body Art: Know The Risks o Body Art: Aftercare o Body Art: Medical Attention
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