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.
47
48 Be It Enacted by the Legislature of the State of Florida:
49
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.
165
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.