Florida Senate - 2013                              CS for SB 278
       By the Committee on Health Policy; and Senator Richter
       588-01737-13                                           2013278c1
    1                        A bill to be entitled                      
    2         An act relating to the practice of optometry; amending
    3         s. 463.002, F.S.; requiring a licensed practitioner
    4         who is not a certified optometrist to display a
    5         specifically worded sign; revising definitions;
    6         defining the term “ocular pharmaceutical agent”;
    7         amending s. 463.005, F.S.; authorizing the Board of
    8         Optometry to adopt rules relating to the
    9         administration and prescription of ocular
   10         pharmaceutical agents; amending s. 463.0055, F.S.;
   11         requiring a certified optometrist to complete a course
   12         and examination on general and ocular pharmaceutical
   13         agents before administering or prescribing oral ocular
   14         pharmaceutical agents; specifying the number of
   15         required course hours based on the date of licensure;
   16         requiring the Florida Medical Association and the
   17         Florida Optometric Association to jointly develop and
   18         administer the course and examination; revising
   19         provisions relating to the development of a formulary
   20         of pharmaceutical agents; amending s. 463.0057, F.S.;
   21         prohibiting the holder of an optometric faculty
   22         certificate from administering or prescribing
   23         pharmaceutical agents; amending s. 463.006, F.S.;
   24         revising provisions relating to licensure and
   25         certification of optometrists; amending s. 463.0135,
   26         F.S.; authorizing a certified optometrist to perform
   27         certain eye examinations; amending s. 463.014, F.S.;
   28         prohibiting a licensed practitioner of optometry from
   29         providing any drug for the purpose of treating a
   30         systemic disease; amending s. 483.035, F.S.; requiring
   31         a clinical laboratory operated by a licensed
   32         practitioner of optometry to be licensed under ch.
   33         463, F.S.; amending s. 483.041, F.S.; revising the
   34         definition of the term “licensed practitioner” to
   35         include certified optometrists; amending s. 483.181,
   36         F.S.; providing for an optometrist to accept a human
   37         specimen for examination, under certain conditions;
   38         amending s. 893.02, F.S.; redefining the term
   39         “practitioner” to include certified optometrists;
   40         amending s. 893.05, F.S.; prohibiting a certified
   41         optometrist from administering or prescribing
   42         pharmaceutical agents listed in Schedule I or Schedule
   43         II of the Florida Comprehensive Drug Abuse Prevention
   44         and Control Act; authorizing certain certified
   45         optometrists to administer certain oral analgesics;
   46         providing an effective date.
   48  Be It Enacted by the Legislature of the State of Florida:
   50         Section 1. Paragraph (b) of subsection (3) and subsections
   51  (4) and (5) of section 463.002, Florida Statutes, are amended,
   52  and subsection (11) is added to that section, to read:
   53         463.002 Definitions.—As used in this chapter, the term:
   54         (3)
   55         (b) A licensed practitioner who is not a certified
   56  optometrist is shall be required to display at her or his place
   57  of practice a sign that which states, “I am a licensed
   58  practitioner, not a certified optometrist, and I am not able to
   59  prescribe topical ocular pharmaceutical agents.”
   60         (4) “Certified optometrist” means a licensed practitioner
   61  authorized by the board to administer and prescribe topical
   62  ocular pharmaceutical agents.
   63         (5) “Optometry” means the diagnosis of conditions of the
   64  human eye and its appendages; the employment of any objective or
   65  subjective means or methods, including the administration of
   66  topical ocular pharmaceutical agents, for the purpose of
   67  determining the refractive powers of the human eyes, or any
   68  visual, muscular, neurological, or anatomic anomalies of the
   69  human eyes and their appendages; and the prescribing and
   70  employment of lenses, prisms, frames, mountings, contact lenses,
   71  orthoptic exercises, light frequencies, and any other means or
   72  methods, including topical ocular pharmaceutical agents, for the
   73  correction, remedy, or relief of any insufficiencies or abnormal
   74  conditions of the human eyes and their appendages.
   75         (11) “Ocular pharmaceutical agent” means a pharmaceutical
   76  agent that is administered topically or orally for the diagnosis
   77  or treatment of ocular conditions of the human eye and its
   78  appendages without the use of surgery or other invasive
   79  techniques.
   80         Section 2. Paragraph (g) of subsection (1) of section
   81  463.005, Florida Statutes, is amended to read:
   82         463.005 Authority of the board.—
   83         (1) The Board of Optometry may has authority to adopt rules
   84  pursuant to ss. 120.536(1) and 120.54 to implement the
   85  provisions of this chapter conferring duties upon it. Such rules
   86  shall include, but are not be limited to, rules relating to:
   87         (g) Administration and prescription of topical ocular
   88  pharmaceutical agents.
   89         Section 3. Section 463.0055, Florida Statutes, is amended
   90  to read:
   91         463.0055 Administration and prescription of topical ocular
   92  pharmaceutical agents; committee.—
   93         (1)(a) Certified optometrists may administer and prescribe
   94  topical ocular pharmaceutical agents as provided in this section
   95  for the diagnosis and treatment of ocular conditions of the
   96  human eye and its appendages without the use of surgery or other
   97  invasive techniques. However, a licensed practitioner who is not
   98  certified may use topically applied anesthetics solely for the
   99  purpose of glaucoma examinations, but is otherwise prohibited
  100  from administering or prescribing topical ocular pharmaceutical
  101  agents.
  102         (b) 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 consists of 50 contact hours, with 25 of
  108  those hours web-based. For certified optometrists licensed on or
  109  after January 1, 1990, the course consists of 20 contact hours,
  110  with 10 of those hours web-based. The first course and
  111  examination shall be presented by July 1, 2013, and shall be
  112  administered at least annually thereafter. The Florida Medical
  113  Association and the Florida Optometric Association shall jointly
  114  develop and administer a course and examination for such purpose
  115  and jointly determine the site or sites for the course and
  116  examination.
  117         (2)(a) There is hereby created a committee composed of two
  118  certified optometrists licensed pursuant to this chapter,
  119  appointed by the Board of Optometry, two board-certified
  120  ophthalmologists licensed pursuant to chapter 458 or chapter
  121  459, appointed by the Board of Medicine, and one additional
  122  person with a doctorate degree in pharmacology who is not
  123  licensed pursuant to chapter 458, chapter 459, or this chapter,
  124  appointed by the State Surgeon General. The committee shall
  125  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 committee’s opinions
  130  and recommendations must state specific findings of fact and
  131  grounds for its recommendation. The committee’s findings,
  132  opinions, and recommendations are not subject to review pursuant
  133  to ss. 120.569 and 120.57. The formulary shall consist of those
  134  topical ocular pharmaceutical agents that which are appropriate
  135  to treat and diagnose ocular diseases and disorders and which
  136  the certified optometrist is qualified to use in the practice of
  137  optometry. The board shall establish, add to, delete from, or
  138  modify the formulary by rule. The board is bound by the
  139  committee’s recommendations on oral ocular pharmaceutical agents
  140  unless competent substantial evidence is presented to the board
  141  sufficient to rebut the committee’s recommendation.
  142  Notwithstanding any provision of chapter 120 to the contrary,
  143  the formulary rule becomes shall become effective 60 days from
  144  the date it is filed with the Secretary of State.
  145         (b) The formulary may be added to, deleted from, or
  146  modified according to the procedure described in paragraph (a).
  147  A Any person who requests an addition, deletion, or modification
  148  of an authorized topical ocular pharmaceutical agent has shall
  149  have the burden of proof to show cause why such addition,
  150  deletion, or modification should be made.
  151         (c) The State Surgeon General has shall have standing to
  152  challenge a any rule or proposed rule of the board pursuant to
  153  s. 120.56. In addition to challenges to an for any invalid
  154  exercise of delegated legislative authority, the administrative
  155  law judge, upon such a challenge by the State Surgeon General,
  156  may declare all or part of a rule or proposed rule invalid if
  157  it:
  158         1. Does not protect the public from any significant and
  159  discernible harm or damages;
  160         2. Unreasonably restricts competition or the availability
  161  of professional services in the state or in a significant part
  162  of the state; or
  163         3. Unnecessarily increases the cost of professional
  164  services without a corresponding or equivalent public benefit.
  166  However, there shall not be created a presumption of the
  167  existence of any of the conditions cited in this subsection is
  168  not created in the event that the rule or proposed rule is
  169  challenged.
  170         (d) Upon adoption of the formulary required by this
  171  section, and upon each addition, deletion, or modification to
  172  the formulary, the board shall mail a copy of the amended
  173  formulary to each certified optometrist and to each pharmacy
  174  licensed by the state.
  175         (3) A certified optometrist shall be issued a prescriber
  176  number by the board. Any prescription written by a certified
  177  optometrist for an a topical ocular pharmaceutical agent
  178  pursuant to this section must include shall have the prescriber
  179  number printed thereon.
  180         Section 4. Subsection (3) of section 463.0057, Florida
  181  Statutes, is amended to read:
  182         463.0057 Optometric faculty certificate.—
  183         (3) The holder of a faculty certificate may engage in the
  184  practice of optometry as permitted by this section, but may not
  185  administer or prescribe topical ocular pharmaceutical agents
  186  unless the certificateholder has satisfied the requirements of
  187  ss. 463.0055(1)(b) and s. 463.006(1)(b)4. and 5.
  188         Section 5. Subsections (2) and (3) of section 463.006,
  189  Florida Statutes, are amended to read:
  190         463.006 Licensure and certification by examination.—
  191         (2) The examination consists shall consist of the
  192  appropriate subjects, including applicable state laws and rules
  193  and general and ocular pharmacology with emphasis on the use
  194  topical application and side effects of ocular pharmaceutical
  195  agents. The board may by rule substitute a national examination
  196  as part or all of the examination and may by rule offer a
  197  practical examination in addition to the written examination.
  198         (3) Each applicant who successfully passes the examination
  199  and otherwise meets the requirements of this chapter is entitled
  200  to be licensed as a practitioner and to be certified to
  201  administer and prescribe topical ocular pharmaceutical agents in
  202  the diagnosis and treatment of ocular conditions.
  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 may perform any eye
  207  examination, including a dilated examination, required or
  208  authorized by chapter 548 or by rules adopted to implement that
  209  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) Prescribing, ordering, dispensing, administering,
  214  supplying, selling, or giving any drug for the purpose of
  215  treating a systemic disease systemic drugs by a licensed
  216  practitioner is prohibited.
  217         Section 8. Subsection (1) of section 483.035, Florida
  218  Statutes, is amended to read:
  219         483.035 Clinical laboratories operated by practitioners for
  220  exclusive use; licensure and regulation.—
  221         (1) A clinical laboratory operated by one or more
  222  practitioners licensed under chapter 458, chapter 459, chapter
  223  460, chapter 461, chapter 462, chapter 463, or chapter 466,
  224  exclusively in connection with the diagnosis and treatment of
  225  their own patients, must be licensed under this part and must
  226  comply with the provisions of this part, except that the agency
  227  shall adopt rules for staffing, for personnel, including
  228  education and training of personnel, for proficiency testing,
  229  and for construction standards relating to the licensure and
  230  operation of the laboratory based upon and not exceeding the
  231  same standards contained in the federal Clinical Laboratory
  232  Improvement Amendments of 1988 and the federal regulations
  233  adopted thereunder.
  234         Section 9. Subsection (7) of section 483.041, Florida
  235  Statutes, is amended to read:
  236         483.041 Definitions.—As used in this part, the term:
  237         (7) “Licensed practitioner” means a physician licensed
  238  under chapter 458, chapter 459, chapter 460, or chapter 461, or
  239  chapter 463; a dentist licensed under chapter 466; a person
  240  licensed under chapter 462; or an advanced registered nurse
  241  practitioner licensed under part I of chapter 464; or a duly
  242  licensed practitioner from another state licensed under similar
  243  statutes who orders examinations on materials or specimens for
  244  nonresidents of the State of Florida, but who reside in the same
  245  state as the requesting licensed practitioner.
  246         Section 10. Subsection (5) of section 483.181, Florida
  247  Statutes, is amended to read:
  248         483.181 Acceptance, collection, identification, and
  249  examination of specimens.—
  250         (5) A clinical laboratory licensed under this part must
  251  accept a human specimen submitted for examination by a
  252  practitioner licensed under chapter 458, chapter 459, chapter
  253  460, chapter 461, chapter 462, chapter 463, s. 464.012, or
  254  chapter 466, if the specimen and test are the type performed by
  255  the clinical laboratory. A clinical laboratory may only refuse a
  256  specimen based upon a history of nonpayment for services by the
  257  practitioner. A clinical laboratory may shall not charge
  258  different prices for tests based upon the chapter under which a
  259  practitioner submitting a specimen for testing is licensed.
  260         Section 11. Subsection (21) of section 893.02, Florida
  261  Statutes, is amended to read:
  262         893.02 Definitions.—The following words and phrases as used
  263  in this chapter shall have the following meanings, unless the
  264  context otherwise requires:
  265         (21) “Practitioner” means a physician licensed pursuant to
  266  chapter 458, a dentist licensed pursuant to chapter 466, a
  267  veterinarian licensed pursuant to chapter 474, an osteopathic
  268  physician licensed pursuant to chapter 459, a naturopath
  269  licensed pursuant to chapter 462, a certified optometrist
  270  licensed pursuant to chapter 463, or a podiatric physician
  271  licensed pursuant to chapter 461, provided such practitioner
  272  holds a valid federal controlled substance registry number.
  273         Section 12. Subsection (1) of section 893.05, Florida
  274  Statutes, is amended to read:
  275         893.05 Practitioners and persons administering controlled
  276  substances in their absence.—
  277         (1) A practitioner, in good faith and in the course of his
  278  or her professional practice only, may prescribe, administer,
  279  dispense, mix, or otherwise prepare a controlled substance, or
  280  the practitioner may cause the same to be administered by a
  281  licensed nurse or an intern practitioner under his or her
  282  direction and supervision only. A veterinarian may so prescribe,
  283  administer, dispense, mix, or prepare a controlled substance for
  284  use on animals only, and may cause it to be administered by an
  285  assistant or orderly under the veterinarian’s direction and
  286  supervision only. A certified optometrist licensed under chapter
  287  463 may not administer or prescribe pharmaceutical agents listed
  288  in Schedule I or Schedule II of s. 893.03. A certified
  289  optometrist who has complied with the provisions of section
  290  463.0055(1)(b) may administer oral analgesics listed in Schedule
  291  III, IV, or V for the relief of pain due to ocular conditions of
  292  the eye and its appendages.
  293         Section 13. This act shall take effect July 1, 2013.