Florida Senate - 2013                                     SB 278
       By Senator Richter
       23-00197A-13                                           2013278__
    1                        A bill to be entitled                      
    2         An act relating to optometry; amending s. 463.002,
    3         F.S.; revising definitions; amending s. 463.005, F.S.;
    4         revising a reference to ocular pharmaceutical agents;
    5         amending and reordering s. 463.0055, F.S.; revising
    6         references to ocular pharmaceutical agents; requiring
    7         certified optometrists to complete a course and
    8         examination on general and ocular pharmaceutical
    9         agents; requiring the Florida Medical Association and
   10         the Florida Optometric Association to jointly
   11         administer, develop, and determine the course site for
   12         the course and examination; requiring the associations
   13         to present the first course and examination by a
   14         specified date and to administer the course and
   15         examination at least annually; requiring two
   16         optometrists appointed to the formulary committee to
   17         be licensed and certified; requiring that the
   18         formulary consist of pharmaceutical agents that are
   19         appropriate to treat and diagnose ocular diseases and
   20         disorders; amending s. 463.0057, F.S.; revising
   21         reference to ocular pharmaceutical agents; adding a
   22         cross-reference to changes made by the act; amending
   23         s. 463.006, F.S.; revising reference to ocular
   24         pharmaceutical agents; incorporating mandating
   25         language that was removed from the definitions;
   26         amending s. 463.0135, F.S.; providing that a certified
   27         optometrist is authorized to perform any eye
   28         examination required or authorized by chapter 548;
   29         amending s. 463.014, F.S.; making technical and
   30         grammatical changes; amending s. 483.035, F.S.,
   31         relating to licensure and regulation of clinical
   32         laboratories operated by practitioners for exclusive
   33         use; providing applicability to clinical laboratories
   34         operated by practitioners licensed to practice
   35         optometry; amending s. 483.041, F.S.; revising the
   36         definition of the term “licensed practitioner” to
   37         include a practitioner licensed under ch. 463, F.S.;
   38         amending s. 483.181, F.S.; requiring clinical
   39         laboratories to accept human specimens submitted by
   40         practitioners licensed to practice under ch. 463,
   41         F.S.; amending s. 893.02, F.S.; revising the
   42         definition of the term “practitioner” to include
   43         certified optometrists for purposes of the Florida
   44         Comprehensive Drug Abuse Prevention and Control Act;
   45         amending s. 893.05, F.S.; prohibiting a certified
   46         optometrist from administering and prescribing certain
   47         controlled substances; providing an effective date.
   49  Be It Enacted by the Legislature of the State of Florida:
   51         Section 1. Subsections (3), (4), and (5) of section
   52  463.002, Florida Statutes, are amended to read:
   53         463.002 Definitions.—As used in this chapter, the term:
   54         (3)(a) “Licensed practitioner” means a person who is a
   55  primary health care provider licensed to engage in the practice
   56  of optometry under the authority of this chapter.
   57         (b) A licensed practitioner who is not a certified
   58  optometrist shall be required to display at her or his place of
   59  practice a sign which states, “I am a Licensed Practitioner, not
   60  a Certified Optometrist, and I am not able to prescribe topical
   61  ocular pharmaceutical agents.”
   62         (c) All practitioners initially licensed after July 1,
   63  1993, must be certified optometrists.
   64         (4) “Certified optometrist” means a licensed practitioner
   65  authorized by the board to administer and prescribe topical
   66  ocular pharmaceutical agents.
   67         (5) “Optometry” means the diagnosis of conditions of the
   68  human eye and its appendages; the employment of any objective or
   69  subjective means or methods, including the administration of
   70  topical ocular pharmaceutical agents, for the purpose of
   71  determining the refractive powers of the human eyes, or any
   72  visual, muscular, neurological, or anatomic anomalies of the
   73  human eyes and their appendages; and the prescribing and
   74  employment of lenses, prisms, frames, mountings, contact lenses,
   75  orthoptic exercises, light frequencies, and any other means or
   76  methods, including topical ocular pharmaceutical agents, for the
   77  correction, remedy, or relief of any insufficiencies or abnormal
   78  conditions of the human eyes and their appendages.
   79         Section 2. Paragraph (g) of subsection (1) of section
   80  463.005, Florida Statutes, is amended to read:
   81         463.005 Authority of the board.—
   82         (1) The Board of Optometry has authority to adopt rules
   83  pursuant to ss. 120.536(1) and 120.54 to implement the
   84  provisions of this chapter conferring duties upon it. Such rules
   85  shall include, but not be limited to, rules relating to:
   86         (g) Administration and prescription of topical ocular
   87  pharmaceutical agents.
   88         Section 3. Section 463.0055, Florida Statutes, is reordered
   89  and amended to read:
   90         463.0055 Administration and prescription of topical ocular
   91  pharmaceutical agents; course and examination on pharmaceutical
   92  agents; prescriber number; formulary committee.—
   93         (1) A certified optometrist optometrists may administer and
   94  prescribe topical ocular pharmaceutical agents as provided in
   95  this section for the diagnosis and treatment of ocular
   96  conditions of the human eye and its appendages without the use
   97  of surgery or other invasive techniques. However, A licensed
   98  practitioner who is not certified may use topically applied
   99  anesthetics solely for the purpose of glaucoma examinations, but
  100  is otherwise prohibited from administering or prescribing
  101  topical ocular pharmaceutical agents.
  102         (2)Before a certified optometrist may administer or
  103  prescribe oral ocular pharmaceutical agents, the certified
  104  optometrist must complete a course and subsequent examination on
  105  general and ocular pharmaceutical agents and the side effects of
  106  those agents. For certified optometrists licensed before January
  107  1, 1990, the course must consist of 50 contact hours, and 25 of
  108  those hours must be Internet-based. For certified optometrists
  109  licensed on or after January 1, 1990, the course must consist of
  110  20 contact hours, and 10 of those hours must be Internet-based.
  111  The Florida Medical Association and the Florida Optometric
  112  Association shall jointly develop and administer such course and
  113  examination and jointly determine the site or sites for the
  114  course and examination. The associations shall present the first
  115  course and examination by January 1, 2014, and shall thereafter
  116  administer the course and examination at least annually.
  117         (4)(2)(a) There is hereby created a committee composed of
  118  two optometrists licensed and certified pursuant to this
  119  chapter, appointed by the Board of Optometry;, two board
  120  certified ophthalmologists licensed pursuant to chapter 458 or
  121  chapter 459, appointed by the Board of Medicine;, and one
  122  additional person with a doctorate degree in pharmacology who is
  123  not licensed pursuant to chapter 458, chapter 459, or this
  124  chapter, appointed by the State Surgeon General. The committee
  125  shall review requests for additions to, deletions from, or
  126  modifications of a formulary of topical ocular pharmaceutical
  127  agents for administration and prescription by certified
  128  optometrists and shall provide to the board advisory opinions
  129  and recommendations on such requests. The formulary must shall
  130  consist of those topical ocular pharmaceutical agents which are
  131  appropriate to treat and diagnose ocular diseases and disorders
  132  and which the certified optometrist is qualified to use in the
  133  practice of optometry. The board shall establish, add to, delete
  134  from, or modify the formulary by rule. Notwithstanding any
  135  provision of chapter 120 to the contrary, the formulary rule
  136  shall become effective 60 days from the date it is filed with
  137  the Secretary of State.
  138         (b) The formulary may be added to, deleted from, or
  139  modified according to the procedure described in paragraph (a).
  140  Any person who requests an addition, deletion, or modification
  141  of an authorized topical ocular pharmaceutical agent has shall
  142  have the burden of proof to show cause why such addition,
  143  deletion, or modification should be made.
  144         (c) The State Surgeon General has shall have standing to
  145  challenge any rule or proposed rule of the board pursuant to s.
  146  120.56. In addition to challenges for any invalid exercise of
  147  delegated legislative authority, the administrative law judge,
  148  upon such a challenge by the State Surgeon General, may declare
  149  all or part of a rule or proposed rule invalid if it:
  150         1. Does not protect the public from any significant and
  151  discernible harm or damages;
  152         2. Unreasonably restricts competition or the availability
  153  of professional services in the state or in a significant part
  154  of the state; or
  155         3. Unnecessarily increases the cost of professional
  156  services without a corresponding or equivalent public benefit.
  158  However, there shall not be created a presumption of the
  159  existence of any of the conditions cited in this subsection is
  160  not created if in the event that the rule or proposed rule is
  161  challenged.
  162         (d) Upon adoption of the formulary required by this
  163  section, and upon each addition, deletion, or modification to
  164  the formulary, the board shall mail a copy of the amended
  165  formulary to each certified optometrist and to each pharmacy
  166  licensed by the state.
  167         (3) A certified optometrist shall be issued a prescriber
  168  number by the board. Any prescription written by a certified
  169  optometrist for a topical ocular pharmaceutical agent pursuant
  170  to this section must shall have the prescriber number printed
  171  thereon.
  172         Section 4. Subsection (3) of section 463.0057, Florida
  173  Statutes, is amended to read:
  174         463.0057 Optometric faculty certificate.—
  175         (3) The holder of a faculty certificate may engage in the
  176  practice of optometry as permitted by this section, but may not
  177  administer or prescribe topical ocular pharmaceutical agents
  178  unless the certificateholder has satisfied the requirements of
  179  ss. 463.0055(2) and s. 463.006(1)(b)4. and 5.
  180         Section 5. Subsections (2) and (3) of section 463.006,
  181  Florida Statutes, are amended, and subsections (4) and (5) are
  182  added to that section, to read:
  183         463.006 Licensure and certification by examination.—
  184         (2) The examination must shall consist of the appropriate
  185  subjects, including applicable state laws and rules and general
  186  and ocular pharmacology with emphasis on the use topical
  187  application and side effects of ocular pharmaceutical agents.
  188  The board may by rule substitute a national examination as part
  189  or all of the examination and may by rule offer a practical
  190  examination in addition to the written examination.
  191         (3) An Each applicant who successfully passes the
  192  examination and otherwise meets the requirements of this chapter
  193  is entitled to be licensed as a practitioner and to be certified
  194  to administer and prescribe topical ocular pharmaceutical agents
  195  in the diagnosis and treatment of ocular conditions.
  196         (4) A licensed practitioner who is not a certified
  197  optometrist shall display at her or his place of practice a sign
  198  that states, “I am a Licensed Practitioner, not a Certified
  199  Optometrist, and I am not able to prescribe ocular
  200  pharmaceutical agents.”
  201         (5) A practitioner initially licensed after July 1, 1993,
  202  must be a certified optometrist.
  203         Section 6. Subsection (10) is added to section 463.0135,
  204  Florida Statutes, to read:
  205         463.0135 Standards of practice.—
  206         (10) A certified optometrist is authorized to perform any
  207  eye examination, including a dilated examination, required or
  208  authorized by chapter 548 or by rules adopted to implement the
  209  provisions of that chapter.
  210         Section 7. Subsection (3) of section 463.014, Florida
  211  Statutes, is amended to read:
  212         463.014 Certain acts prohibited.—
  213         (3) A licensed practitioner may not prescribe, order,
  214  dispense, administer, supply, sell, or give any drug for the
  215  purpose of treating a systemic disease Prescribing, ordering,
  216  dispensing, administering, supplying, selling, or giving any
  217  systemic drugs by a licensed practitioner is prohibited.
  218         Section 8. Subsection (1) of section 483.035, Florida
  219  Statutes, is amended to read:
  220         483.035 Clinical laboratories operated by practitioners for
  221  exclusive use; licensure and regulation.—
  222         (1) A clinical laboratory operated by one or more
  223  practitioners licensed under chapter 458, chapter 459, chapter
  224  460, chapter 461, chapter 462, chapter 463, or chapter 466,
  225  exclusively in connection with the diagnosis and treatment of
  226  their own patients, must be licensed under this part and must
  227  comply with the provisions of this part, except that the agency
  228  shall adopt rules for staffing, for personnel, including
  229  education and training of personnel, for proficiency testing,
  230  and for construction standards relating to the licensure and
  231  operation of the laboratory based upon and not exceeding the
  232  same standards contained in the federal Clinical Laboratory
  233  Improvement Amendments of 1988 and the federal regulations
  234  adopted thereunder.
  235         Section 9. Subsection (7) of section 483.041, Florida
  236  Statutes, is amended to read:
  237         483.041 Definitions.—As used in this part, the term:
  238         (7) “Licensed practitioner” means a physician licensed
  239  under chapter 458, chapter 459, chapter 460, or chapter 461, or
  240  chapter 463; a dentist licensed under chapter 466; a person
  241  licensed under chapter 462; or an advanced registered nurse
  242  practitioner licensed under part I of chapter 464; or a duly
  243  licensed practitioner from another state licensed under similar
  244  statutes who orders examinations on materials or specimens for
  245  nonresidents of the State of Florida, but who reside in the same
  246  state as the requesting licensed practitioner.
  247         Section 10. Subsection (5) of section 483.181, Florida
  248  Statutes, is amended to read:
  249         483.181 Acceptance, collection, identification, and
  250  examination of specimens.—
  251         (5) A clinical laboratory licensed under this part must
  252  accept a human specimen submitted for examination by a
  253  practitioner licensed under chapter 458, chapter 459, chapter
  254  460, chapter 461, chapter 462, chapter 463, s. 464.012, or
  255  chapter 466, if the specimen and test are the type performed by
  256  the clinical laboratory. A clinical laboratory may only refuse a
  257  specimen based upon a history of nonpayment for services by the
  258  practitioner. A clinical laboratory may shall not charge
  259  different prices for tests based upon the chapter under which a
  260  practitioner submitting a specimen for testing is licensed.
  261         Section 11. Subsection (21) of section 893.02, Florida
  262  Statutes, is amended to read:
  263         893.02 Definitions.—The following words and phrases as used
  264  in this chapter shall have the following meanings, unless the
  265  context otherwise requires:
  266         (21) “Practitioner” means a physician licensed pursuant to
  267  chapter 458, a dentist licensed pursuant to chapter 466, a
  268  veterinarian licensed pursuant to chapter 474, an osteopathic
  269  physician licensed pursuant to chapter 459, a naturopath
  270  licensed pursuant to chapter 462, a certified optometrist
  271  licensed pursuant to chapter 463, or a podiatric physician
  272  licensed pursuant to chapter 461, if provided such practitioner
  273  holds a valid federal controlled substance registry number.
  274         Section 12. Subsection (1) of section 893.05, Florida
  275  Statutes, is amended to read:
  276         893.05 Practitioners and persons administering controlled
  277  substances in their absence.—
  278         (1) A practitioner, in good faith and in the course of his
  279  or her professional practice only, may prescribe, administer,
  280  dispense, mix, or otherwise prepare a controlled substance, or
  281  the practitioner may cause the same to be administered by a
  282  licensed nurse or an intern practitioner under his or her
  283  direction and supervision only. A veterinarian may so prescribe,
  284  administer, dispense, mix, or prepare a controlled substance for
  285  use on animals only, and may cause it to be administered by an
  286  assistant or orderly under the veterinarian’s direction and
  287  supervision only. An optometrist licensed and certified under
  288  chapter 463 may not administer or prescribe a controlled
  289  substance in Schedule I or Schedule II of the Florida
  290  Comprehensive Drug Abuse Prevention and Control Act.
  291         Section 13. This act shall take effect July 1, 2013.