SB1033 - 501R

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 32-1701, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1701. Definitions

In this chapter, unless the context otherwise requires:

1. "Board" means the state board of optometry.

2. "Conviction" means a judgment of conviction by any state or federal court of competent jurisdiction in a criminal cause, regardless of whether an appeal is pending or could be taken, and includes any judgment or order based on a plea of no contest.

3. "Licensee" means a person licensed to practice the profession of optometry pursuant to this chapter.

4. "Optometrist" or "doctor of optometry" means a person who has graduated from an accredited college of optometry.

5. "Pharmaceutical" or "pharmaceutical agent" means a prescription or nonprescription substance or a schedule III controlled substance used for examination, diagnosis or treatment of conditions of the human eye and its adnexa.

6. "Practice of the profession of optometry" means:

(a) The examination or refraction of the human eye and its appendages and the employment of any objective or subjective means or methods other than surgery for the purpose of diagnosing or treating any visual, muscular, neurological or anatomical anomalies of the eye.

(b) The use of pharmaceutical agents authorized pursuant to this chapter.

(c) The use of any instrument, computer program, lens, prism or device to train the visual system or correct any abnormal condition of the eye or eyes, including orthoptics, pleoptics, vision therapy or neurorehabilitation of the visual system or any similar technique.

(d) The prescribing, fitting or employment of any lens, prism, frame or mountings for the correction or relief of or aid to the visual function, provided that superficial foreign bodies may be removed from the eye and its appendages.

(e) The taking of smears of the human eye and its adnexa for culture analysis and the ordering or performing of clinical tests that are appropriate to diagnose, treat or manage conditions of the human eye and its adnexa and that are limited to those CLIA‑waived clinical tests approved pursuant to 42 Code of Federal Regulations section 493.15.

7. "Surgery" means, in reference to the human eye and its appendages, an invasive procedure in which in vivo human tissue is cut, burned, vaporized, removed, coagulated or photodisrupted by use of an electrical cautery, a scalpel, a cryoprobe, a laser or ionizing radiation. Surgery does not include nonsurgical procedures, including the removal of superficial foreign bodies or eyelashes or the use of lasers for diagnostic purposes.

8. "Unprofessional conduct" means:

(a) Wilful betrayal of a professional secret or wilful violation of a privileged communication except as otherwise required by law.

(b) Charging a fee for services not rendered or dividing a professional fee for patient referrals among health care providers or health care institutions or between these providers and institutions or a contractual arrangement that has the same effect. This subdivision does not prohibit a bona fide lease based on the revenues earned by a licensee.

(c) Addiction to, or illegal use of, narcotic drugs or use of intoxicating beverages to excess or practicing or attempting to practice the profession of optometry while under the influence of intoxicating beverages or narcotic drugs.

(d) Impersonating another licensee.

(e) Knowingly having professional connection with or lending one's name to a person who is not a licensee.

(f) Gross negligence, repeated or continuing acts of negligence or incompetence in the practice of optometry.

(g) Any conduct or practice, including incompetency, that constitutes a danger to the health, welfare or safety of patients or the public.

(h) Prescribing, dispensing or pretending to use any secret means, methods, device or instrumentality.

(i) Refusing to divulge to the board on demand the means, methods, device or instrumentality used for optometric examination or therapy.

(j) Representing that a manifestly not correctable condition can be permanently corrected or that a correctable condition can be corrected within a stated time if this is not accurate.

(k) Knowingly making any false or fraudulent statement, written or oral, in connection with the practice of the profession of optometry.

(l) Failing to comply with a board order or consent agreement.

(m) Fraud, forgery, unsworn falsification, false swearing or perjury involving a matter before the board or a written instrument submitted to the board.

(n) Wilfully and without legal justification failing to furnish in a timely manner information that is necessary for the board to conduct an investigation under this chapter and that has been requested or subpoenaed by the board.

(o) Conduct that discredits the profession.

(p) Sexual intimacies with a patient in the course of care or treatment.

(q) Falsely claiming attendance at a required continuing education course.

(r) Transferring the authority or care of a patient to a person who is not licensed pursuant to this chapter or who is not an employee of a person who is licensed pursuant to this chapter or chapter 13 or 17 of this title. END_STATUTE

Sec. 2. Section 32-1702, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1702. Board of optometry; appointment; qualifications; term; removal

A. There is established a state board of optometry which consists of six members appointed by the governor. Terms of office are for four years expiring on July 1 of the respective year. Four members shall have been licensed and engaged in the active practice of the profession of optometry in this state for at least three years immediately prior to appointment, one member shall be a physician licensed pursuant to chapter 13 or 17 of this title, and one member shall be a lay person with no interest, direct or indirect, in the practices of optometry, opticianry or medicine.

A. The state board of optometry is established consisting of the following members who are appointed by the governor to staggered four-year terms that end on July 1:

1. Five members who have been licensed and engaged in the active practice of optometry in this state for at least three years immediately before the appointment.

2. Two public members who do not have a direct or indirect interest in the practice of optometry, opticianry or medicine.

B. The governor may remove any professional member for incompetency or unprofessional conduct or when his if the member's license has been revoked or suspended or when he if the member has been censured or placed on probation. The governor may remove any member for neglect of duty or improper conduct. The unexcused absence of a member for more than two consecutive meetings is justification for removal. Appointment by the governor to fill a vacancy caused other than by expiration of a term is for the unexpired portion of the term.

C. A member of the board is ineligible to serve more than two consecutive full terms. The completion of the unexpired portion of a full term does not constitute a full term for purposes of this subsection.

D. The board shall conduct regular meetings at least six times each year at times and places designated by the board or the governor. Special meetings may be called that the president determines are necessary to carry out the functions of the board, including meetings using communications equipment that allows all members participating in the meetings to hear each other.

E. A majority of the members of the board constitutes a quorum and a majority vote of a quorum present at any meeting governs all actions taken by the board. END_STATUTE

Sec. 3. Section 32-1706, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1706. Use of pharmaceutical agents

A. A licensee may prescribe, dispense and administer over‑the‑counter pharmaceuticals and topical prescription pharmaceuticals subject to the pharmaceutical agent classifications specified in section 32‑1728.

B. A licensee may prescribe, dispense and administer the following oral prescription pharmaceuticals subject to the pharmaceutical agent classifications specified in section 32‑1728:

1. Antibiotics classified as tetracycline and its derivatives, cephalosporins, penicillin and its derivatives and macrolides and antivirals for the treatment of diseases of the eye and its adnexa. A licensee may prescribe these antibiotics and antivirals for any one patient for each occurrence for a period not more than the day limit recommended by the manufacturer or by the physicians' desk reference. If the patient's condition is other than blepharitis and does not improve during the first seventy‑two hours of treatment by means of an oral antibiotic or an oral antiviral, the licensee shall consult with the patient's primary care physician or other family physician for the purpose of referral of the patient to a physician who specializes in ophthalmology, infectious diseases, internal medicine or neurology. After the referral has been made, the licensee shall consult with the specialist. The licensee shall note the consultation in the patient's file. If the treatment is by oral antibiotics for blepharitis and if the patient's condition does not improve during the first ten days of treatment, the licensee shall request the patient's primary care physician or other family physician to refer the patient to a physician who specializes in ophthalmology, infectious diseases, internal medicine or neurology. On notification of the referral the licensee shall consult with the specialist. The licensee shall note the consultation in the patient's file. If the condition is not resolved at the end of the normal treatment period, the licensee shall request the patient's primary care physician or other family physician to refer the patient to a physician who specializes in ophthalmology, infectious diseases, internal medicine or neurology. On notification of the referral the licensee shall consult with the specialist. The licensee shall note the consultation in the patient's file. A licensee shall not prescribe, dispense or administer an oral antibiotic or an oral antiviral to a person who is under six years of age. For the purposes of this paragraph, "physician" means a person who is licensed pursuant to chapter 13 or 17 of this title.

2. Antihistamines. A licensee may prescribe an antihistamine for not more than seven days for any one patient for each occurrence. If the patient's condition does not improve during the first seven days of treatment, the licensee shall refer the patient to the patient's primary care physician or other physician licensed pursuant to chapter 13 or 17 of this title.

3. Nonprescription Nonsteroidal anti‑inflammatory agents. A licensee may prescribe, dispense and administer these agents in dosages that exceed over‑the‑counter dosages but that do not exceed maximum dosages of counterpart prescription nonsteroidal anti‑inflammatory agents.

C. A licensee may prescribe, dispense and administer a schedule III controlled substance only if it is an analgesic.

D. A licensee shall not prescribe, dispense or administer the following prescription substances:

1. An oral steroid.

2. An oral antifungal.

3. An oral carbonic anhydrase inhibitor.

4. An oral antimetabolite.

5. An oral immunosuppressive.

6. A substance administered intravenously.

7. Except as provided in subsection E of this section, substances administered by injection.

8. A schedule I, II, IV or V controlled substance.

9. An oral agent for the treatment of closed angle glaucoma attack.

10. Except as provided in subsection B, paragraph 3, an oral nonsteroidal anti‑inflammatory agent.

E. A licensee may use epinephrine auto‑injectors to counteract an anaphylactic reaction. A licensee who uses auto‑injectors may order and maintain anaphylactic‑related supplies. The board shall require a licensee to maintain in the licensee's office medically necessary supportive equipment and supplies that are used in connection with the treatment of an anaphylactic reaction, including oxygen equipment, airway maintenance equipment or other necessary equipment consistent with the prevailing standard of care as specified by the board. END_STATUTE

Sec. 4. Section 32-1722, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1722. Qualifications of applicant; applications

A. A person of good moral character who desires wishes to engage in the practice of the profession of optometry shall file with the board not less than thirty days before the date on which an examination is to be held a verified application with the required application fee that includes:

1. The applicant's name, age and address.

2. Documentation of graduation from a university or college that teaches the profession of optometry and that is accredited by a nationally accepted accrediting body on optometric education.

3. Documentation of satisfactory completion of an equivalent course of study that is approved by the board in didactic education, pharmacology and clinical training in the examination, diagnosis and treatment of conditions of the human eye and its adnexa and that either:

(a) Meets the contemporary educational requirements at colleges of optometry in the United States.

(b) Totals at least one hundred twenty eighty hours.

4. Documentation of the successful passage of a written examination as prescribed by the board.

5. Background information on a form prescribed by the attorney general for the purpose of conducting an investigation into the existence of prior arrests and convictions.

6. Disclosure of any investigation conducted or pending by an optometric regulatory board in another jurisdiction in the United States.

B. On receipt of an application in proper form and containing the information prescribed in subsection A of this section, the board may investigate the applicant's character, ability and experience.

C. For the purposes of an investigation that is conducted pursuant to subsection B of this section, the board may subpoena witnesses, administer oaths and take testimony with respect to the character of the applicant or to any matter affecting the application at a hearing held after sufficient notice has been given.

D. If the board finds that the applicant has passed the examination provided for under section 32‑1724 and that the applicant's character, ability and experience are satisfactory, the board shall issue a license. END_STATUTE

Sec. 5. Section 32-1723, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1723. Licensure by endorsement

The board shall waive the written examination requirements of this chapter if all of the following are true:

1. The applicant submits a license or a certified copy of a license to practice optometry issued by the regulatory board of another jurisdiction of the United States that has licensure requirements that the board determines meet or exceed the requirements of this chapter.

2. The license of the applicant has not been suspended or revoked by any other licensing jurisdiction of the United States for any cause that is a ground for suspension or revocation of a license under this chapter.

3. The applicant has been engaged in the practice of the profession of optometry continuously in the other licensing jurisdiction or in a United States military branch of service for not less than four at least two of the five years immediately preceding the application or in the military.

4. The information provided by national data banks designated by the board has successfully verified the applicant.

5. The applicant meets the requirements of section 32‑1722 concerning good moral character. END_STATUTE

Sec. 6. Section 32-1725, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1725. Issuance of license

The board shall issue to each applicant who satisfactorily passes the examination shall upon payment of the issuance fee be issued and who pays the license issuance fee pursuant to section 32-1727 a license under the seal and signatures of the members of the board. Failure to An applicant who does not pay the issuance fee within sixty days necessitates the retaking of the examination. must submit a new application and all applicable fees pursuant to section 32-1727. END_STATUTE

Sec. 7. Heading change

The article heading of title 32, chapter 16, article 5, Arizona Revised Statutes, is changed from "REPLACEMENT SOFT CONTACT LENSES" to "NONRESIDENT DISPENSERS OF REPLACEMENT SOFT CONTACT LENSES AND PRESCRIPTION EYEGLASSES".

Sec. 8. Section 32-1771, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1771. Definitions

For purposes of In this article, except as unless the context otherwise requires:

1. "Nonresident dispenser" means a person who is not domiciled in this state, who is licensed in the person's state of domicile to dispense replacement soft contact lenses or prescription eyeglasses and who dispenses replacement soft contact lenses or prescription eyeglasses to patients in this state.

2. "Prescription eyeglass" means a lens or prism that has a frame or mountings, that is used to correct, relieve or aid visual function and that is issued pursuant to a prescription written by a licensed person who is authorized to write the prescription.

2. 3. "Qualified dispenser" means a nonresident dispenser holding a current registration with the board.

3. 4. "Replacement soft contact lenses" means hydrophilic lenses requiring no that do not require fitting or adjustment and that are dispensed as packaged and sealed by the manufacturer. END_STATUTE

Sec. 9. Section 32-1773, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1773. Registration of nonresident dispensers; fees; qualifications; civil penalty

A. A nonresident dispenser may register with the board to dispense replacement soft contact lenses or prescription eyeglasses. Registration shall be is effective for two years and subject to renewal.

B. The board shall set a fee for registration and for renewal of registration.

C. Applicants an applicant for registration or renewal shall provide to the board at the time for of registration or renewal on a form prescribed by the board their the applicant's name, and address, the name of principal corporate officers, if any, and the name of all general partners, if any. The registration shall be accompanied by the required fee and a certified copy of the applicant's license from the licensing authority in their the applicant's state of domicile and other information the board requires.

D. Registered dispensers A qualified dispenser shall submit a report to the board within thirty days of after the change of its address, of any officer, partner or pharmacist or of the status of its license in the state of domicile.

E. Registered dispensers A Qualified dispenser shall maintain at all times a valid unexpired license, permit or registration to conduct the business of a pharmacist or pharmacy in their the qualified dispenser's state of domicile.

F. The board may suspend, revoke or refuse to renew the registration of a registered qualified dispenser or impose a civil sanction penalty against a registered qualified dispenser or any other person who:

1. Violates this article.

2. Obtained Obtains a registration by fraudulent or other material misrepresentation.

3. Has been convicted of a felony.

4. Has had their a license suspended or revoked in any other jurisdiction.

5. Violates any other Arizona or federal law regulating the dispensing of replacement soft contact lenses or prescription eyeglasses.

6. Commits an offense in another jurisdiction which that would be grounds for revocation or suspension in this jurisdiction state.

G. The board shall issue a complaint to the registrant and set a hearing, which shall conform to the requirements of title 41, chapter 6.END_STATUTE

Sec. 10. Section 32-1774, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1774. Dispensing of replacement soft contact lenses or prescription eyeglasses by qualified dispensers; prescriptions; warning; disclosures; records

A. A nonresident dispenser may not fill a prescription for replacement soft contact lenses or prescription eyeglasses without first having registered with the board. A qualified dispenser may fill a prescription for replacement soft contact lenses or prescription eyeglasses only as provided in this section.

B. A qualified dispenser may fill a prescription for replacement soft contact lenses or prescription eyeglasses that meets all of the following requirements:

1. Conforms to state and federal statutes and regulations governing those prescriptions and includes the name, office address, signature and state license number of the prescribing physician or optometrist.

2. Explicitly states the date of issuance.

3. Explicitly states that the prescription is for replacement soft contact lenses or prescription eyeglasses and includes the lens brand name, type, and tint and all other specifications necessary to accurately dispense the prescription.

C. The qualified dispenser shall fill the prescription with the exact lenses prescribed, and no substitutions shall not be made. The expiration date of the prescription shall be is the earlier of the expiration date provided by the prescribing physician or optometrist or one year after the date of issuance. The qualified dispenser shall fill a refill of a soft contact lens prescription that is within sixty days of after its expiration date with no more than the sufficient quantity of replacement soft contact lenses needed through the expiration date. The qualified dispenser shall ensure that prescriptions are filled accurately.

D. The qualified dispenser shall provide the following or a substantially equivalent written notification to the patient whenever replacement soft contact lenses are supplied:

Warning: If you are having any unexplained eye discomfort, watering, vision change or redness, remove your lenses immediately and consult your eye care practitioner before wearing your lenses again.

E. Any advertisement by a qualified dispenser for replacement soft contact lenses or prescription eyeglasses shall include information regarding all fees, charges and costs associated with the purchase of replacement soft contact lenses or prescription eyeglasses from the qualified dispenser.

F. During its regular hours of operation, but at least six days per week and for at least forty hours per week, a qualified nonresident dispenser shall maintain a toll-free telephone service to facilitate communication between patients in this state and a registered qualified dispenser who has access to the patient's records. This toll-free number shall be disclosed on a label affixed to each container of replacement soft contact lenses or to the prescription eyeglass case dispensed to patients in this state.

G. Qualified dispensers shall maintain records of replacement soft contact lenses or prescription eyeglasses dispensed to patients in this state separate from records for patients in other states such so that the records for patients in this state are readily retrievable. Records shall be maintained for a period of at least three years. A qualified dispenser must make records shall be available for board inspection at the board's request. END_STATUTE

Sec. 11. Retention of members

Notwithstanding section 32-1702, Arizona Revised Statutes, as amended by this act, all persons serving as members of the state board of optometry on the effective date of this act may continue to serve until the expiration of their normal terms. The governor shall make all subsequent appointments as prescribed by statute.