SB1227 - 561R

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. "Contact lens":

(a) Means an ophthalmic lens that is prescribed for application on the anterior surface of the eye.

(b) Includes any plano lens, cosmetic lens or therapeutic lens.

2. 3. "Conviction":

(a) 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

(b) Includes any judgment or order based on a plea of no contest.

4. "Dispensing" means the retail delivery of ophthalmic goods to a patient.

5. "Fitting" means performing mechanical procedures and measurements necessary to adapt and fit contact lenses after an eye examination and supervising the trial wearing of the contact lenses, which may require revisions during the trial period.

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

7. "Ophthalmic goods" means eyeglasses, one or more eyeglass components for which a prescription is required or contact lenses.

8. "Ophthalmic lens":

(a) Means a refractive or nonrefractive device to correct, relieve or remedy an abnormal condition or inefficiency of the eye or visual process.

(b) Includes a spectacle lens, a contact lens and a protective lens.

9. "Ophthalmic services" means measuring, fitting, adjusting, fabricating or prescribing ophthalmic goods after an eye examination.

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

5. 11. "Pharmaceutical" or "pharmaceutical agent" means a prescription or nonprescription substance or a schedule III controlled substance used for examination, diagnosis examining, diagnosing or treatment of treating 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.

(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.

12. "Practice of the profession of optometry":

(a) Means employing primary human eye care procedures, including:

(i) Examining, diagnosing and treating normal and abnormal conditions and diseases of the eye and its adnexa and visual system.

(ii) Measuring the powers and range of vision of the eye to determine the accommodative and refractive state and general function of the eye.

(iii) Adapting, selling, prescribing and dispensing frames and ophthalmic lenses in all their forms.

(iv) Ordering and performing diagnostic laboratory or imaging tests.

(v) prescribing and administering pharmaceutical agents, as provided in section 32-1706.

(vi) Performing preoperative and postoperative care for those procedures that are excluded from the practice of optometry.

(vii) Performing any procedure as set forth by the board's rules that is not excluded from the practice of optometry.

(b) Does not include laser procedures, nonlaser procedures and surgeries as prescribed in rule by the board.

13. "prescription for contact lenses" means a written directive from an optometrist or physician for contact lenses that:

(a) Must include the manufacturer's brand name, the power and base curve of the contact lenses, the name and telephone number of the prescribing optometrist or physician, the patient's name and the expiration date of the prescription.

(b) May include the diameter, axis, add power, cylinder, peripheral curve, optical zone, edge treatment, coating or center thickness of the contact lenses.

14. "Surgery":

(a) Means a procedure using instruments, including lasers, scalpels, or needles, in which human tissue is opened, burned, vaporized or otherwise altered by any mechanical means, laser or ionizing radiation.

(b) Includes procedures using instruments that require closing by suturing, clamping or another device.

8. 15. "Unprofessional conduct" means:

(a) Wilful betrayal of Wilfully betraying a professional secret or wilful violation of wilfully violating 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 Being addicted to, or illegal use of illegally using, narcotic drugs or use of using 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) Committing gross negligence, repeated or continuing acts of negligence or incompetence in the practice of optometry.

(g) Engaging in 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, including advertising.

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

(m) Committing 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) Engaging in conduct that discredits the profession.

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

(q) Sexually harassing a patient, former patient, research subject, supervisee or coworker, including making nonconsensual sexual advances, sexual solicitations, requests for sexual favors, or unwelcome comments or gestures or engaging in any other verbal or physical conduct of a sexual nature.

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

(r) (s) Soliciting patients by fraudulent or misleading advertising of any kind.

(s) (t) Aiding the practice of optometry by an unlicensed, incompetent or impaired person.

(t) (u) Sharing fees with a person or organization in return for soliciting customers by that person or organization.

(u) (v) Issuing a prescription order contingent on the purchase of ophthalmic services or materials. END_STATUTE

Sec. 2. 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 as provided in section 32-1728.

B. Except as provided in subsection C of this section, a licensee may prescribe, dispense and administer the following oral prescription pharmaceuticals for the treatment of treating diseases of the eye and its adnexa for any one patient for each occurrence for a period of not more than the day limit recommended by the manufacturer or the physicians' desk reference, unless otherwise specified in this subsection, subject to the pharmaceutical agent classifications specified in section 32-1728:

1. Anti-infectives classified as tetracycline and its derivatives, cephalosporins, penicillin and its derivatives, macrolides, fluroquinolones and antivirals.

2. Antihistamines.

3. Nonsteroidal anti-inflammatory agents.

4. Agents for the treatment of treating angle-closure glaucoma, including carbonic anhydrase inhibitors.

5. Steroids in an amount that does not exceed the amount packaged for a single course of therapy of not more than seven days.

C. A licensee may not prescribe, dispense or administer an oral pharmaceutical specified in subsection B of this section or a controlled substance as specified in subsection D of this section to a person who is under six years of age.

D. A licensee may prescribe, dispense and administer a schedule III controlled substance only if it is an analgesic and may prescribe or administer any controlled substance only if it is an analgesic that is reclassified from schedule III to schedule II after January 1, 2014.

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

1. An oral antifungal.

2. An oral antimetabolite.

3. Except for steroidal and nonsteroidal treatment pursuant to this chapter, an oral immunosuppressive.

4. A substance administered intravenously.

5. Except as provided in subsection F of this section, substances administered by injection.

6. Except as provided in subsection D of this section, a schedule I, II, IV or V controlled substance.

F. A licensee may use epinephrine auto-injectors to counteract an anaphylactic reaction. END_STATUTE

Sec. 3. Section 32-1722, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1722. Qualifications of applicant; applications

A. A person An applicant for licensure who wishes to engage in the practice of the profession of optometry shall file with the board a verified application with the required application fee that includes and must meet all of the following:

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

2. Documentation of graduation from a university or college

1. Be a doctoral graduate of an accredited school of optometry that teaches the profession of optometry and that is accredited by a nationally accepted accrediting body on optometric education.

2. Not be guilty of any act of unprofessional conduct or any other conduct that would be grounds for refusal, suspension or revocation of a license under this chapter.

3. If the applicant graduated from a recognized school of optometry BEFORE August 31, 1999, provide 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 examining, diagnosing and treatment of treating conditions of the human eye and its adnexa and that either:

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

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

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

5. Provide 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 Disclose 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 proof that the applicant meets the requirements prescribed in subsection A of this section, the board may investigate the applicant's history, 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 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 ability and experience are satisfactory, The board shall issue or deny a license based on the application submitted. END_STATUTE

Sec. 4. 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 of the five at least two years immediately preceding the application.

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

Sec. 5. Section 32-1724, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1724. Examination of applicants

A. Licensing examinations shall be conducted and graded according to rules prescribed by the board. The board shall not grade examinations on a curve.

B. A. The board may give applicants a written examination on subjects currently being taught in universities or colleges of optometry as well as on this state's statutes and rules relating to the practice of the profession of optometry. In lieu of its written examination for licensure, the board may accept documentation from the national board of examiners in optometry that shows that an applicant has passed board designated parts of the national board's examination. To receive a passing grade on a written examination administered by the board, an applicant shall receive a grade of not less than at least seventy-five per cent percent on the whole written examination and not less than at least fifty per cent percent in any one subject.

C. B. The board may give applicants a practical examination on subjects currently being taught in universities or colleges of optometry and shall give an examination on this state's statutes and rules relating to optometry. In lieu of its practical examination for licensure, the board may accept documentation from the national board of examiners in optometry that shows that the applicant has passed board designated parts of the national board’s examination. To receive a passing grade on a practical or jurisprudence examination, an applicant shall receive a grade of not less than at least seventy-five per cent percent.

D. Examinations shall be held at least once each year. Notice of examinations shall be given not less than sixty days before the date of examination. The board shall adopt rules to establish conditions under which an applicant who is unable to take the examination and who notifies the board before the date fixed for the examination may take the next examination. END_STATUTE

Sec. 6. Section 32-1726, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1726. Renewal of license; continuing education; failure to renew

A. Except as provided in section 32-4301, beginning on September 1, 2001, a licensee who wishes to renew a license must do so every other year on or before the licensee's birthday by submitting a completed renewal form and the renewal fee prescribed by the board. A licensee who does not renew a license within thirty days after the licensee's birthday must also pay a late fee as prescribed by the board. A license expires if the licensee does not renew the license within four months after the licensee's birthday. A person who practices optometry in this state after that person's license has expired is in violation of this chapter.

B. As a condition of renewal or reinstatement, each licensee shall complete thirty-two hours of continuing education as prescribed by the board. The board shall require continuing education on the subject of pharmaceutical use for doctors who are authorized by the board to prescribe, dispense, and administer pharmaceuticals, including opioid-related education hours as prescribed in section 32-3248.02 for licensees who have a valid United States drug enforcement administration registration number. The board may waive or adjust the continuing education requirements for good cause shown.

C. To reinstate an expired license, a person must submit a written application and pay all delinquent biennial fees, all late fees and a fifty dollar $50 penalty fee for each year the license remains unrenewed. The board shall not require the applicant to pass an initial licensing examination if the applicant meets the requirements of this subsection within five years after the license expired.

D. A person holding who holds a license to practice the profession of optometry in this state and who has not engaged in the practice of the profession of optometry within a five year five-year period shall pass an initial licensing examination before the license is renewed. END_STATUTE

Sec. 7. Section 32-1727, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1727. Fees

A. The following fees shall be paid to the board:

1. For filing an application for examination, one hundred fifty dollars an amount as established by the board.

2. For license issuance, fee an amount as established by the board.

3. For renewal of a license to practice the profession of optometry, an amount as established by the board.

4. For late renewal of a license, an amount as established by the board.

5. For an application for a license by endorsement, three hundred dollars an amount as established by the board.

6. For a duplicate license, fee, thirty dollars $30.

7. Certificates of special qualification, twenty dollars.

8. Duplicate certificates of special qualification, twenty dollars.

9. Optometry statute pamphlet fee, five dollars.

B. Fees paid pursuant to this section are not refundable. END_STATUTE

Sec. 8. Section 32-1728, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1728. Pharmaceutical agents; use; certificate for renewal

A. A licensee who is initially licensed after the effective date of the amendment to this section August 9, 2001, a licensee licensed by endorsement after the effective date of the amendment to this section or a licensee who passed an examination conducted by the board for the use of oral pharmaceutical agents before the effective date of the amendment to this section August 9, 2001 may prescribe, dispense and administer a pharmaceutical agent subject to the limitations limits provided in this chapter.

B. The board may reissue a certificate for renewal for the use of pharmaceutical agents for topical diagnostic or topical therapeutic pharmaceutical agents, or both, to a person who holds an existing certificate issued on or before the effective date of the amendment to this section and who pays the certificate of special qualification fee prescribed in section 32-1727 August 9, 2001. The certificate may specify the following:

1. Use of no drugs.

2. Use of topical diagnostic agents.

3. Use of topical diagnostic and therapeutic agents.

C. The board may issue a certificate of special qualification to practice optometry without the use of pharmaceutical agents to a person who holds a current license as of July 1, 2000 and who pays the certificate of special qualification fee prescribed in section 32-1727.

D. The board shall adopt a course of study for certification to use oral pharmaceuticals after consultation with colleges of optometry accredited by a nationally accepted accrediting body on optometric education and with the college of pharmacy at the university of Arizona. The board shall design and implement the course in a manner that requires a licensee who wishes to have the privilege of dispensing, prescribing and administering topical and oral pharmaceutical agents pursuant to this chapter meet the contemporary educational requirements related to pharmaceuticals authorized for licensees pursuant to this chapter at colleges of optometry in the United States and to demonstrate competence in dispensing, prescribing and administering those topical or oral pharmaceutical agents by passing examinations in those areas commensurate with doctoral candidates in colleges of optometry in the United States. The course of study shall teach and certify competence in the prescription and administration of topical or oral pharmaceutical agents pursuant to this chapter. The board shall adopt the course of study and completion requirements to reflect the current course of study and demonstrated competence level of pharmacy programs in colleges of optometry in the United States. The board may offer a course and examination that otherwise meets the requirements of this subsection and that is limited to oral pharmaceuticals for licensees who hold a valid diagnostic and therapeutic topical pharmaceutical permit issued pursuant to subsection A of this section.

E. The board shall adopt a uniform prescription form for use by all licensees who have the privilege to prescribe, dispense and administer topical pharmaceuticals or oral pharmaceuticals. The prescription form shall indicate the prescribing authority of the licensees and whether the authority includes oral pharmaceuticals, topical pharmaceuticals or both oral pharmaceuticals and topical pharmaceuticals. The form shall include the name, address, telephone number, fax number and professional license number of the licensee.

F. Annually on or before January 1 the state board of optometry shall mail to the Arizona state board of pharmacy the list of all licensees who have been certified to prescribe, dispense and administer either oral pharmaceuticals or topical pharmaceuticals, or both. Within thirty days of any additional certification by the state board of optometry, the state board of optometry shall provide updated lists to the Arizona state board of pharmacy. At the same time the state board of optometry shall send the list to each licensed pharmacy in Arizona, excluding hospital pharmacies, long-term care pharmacies and infusion pharmacies. END_STATUTE

Sec. 9. Section 32-1741, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1741. Practicing optometry without a license prohibited; exception

A. It is unlawful for a person to practice the profession of optometry or to hold himself out to be or assume or attempt to act as a doctor of optometry without a valid license to practice the profession of optometry.

B. A person is exempt from the provisions of this chapter regulating the practice of the profession of optometry if the person is enrolled in a clinical program of an undergraduate or graduate course of study in optometry at a school or college of optometry accredited by the board and the person has not received a degree of doctor of optometry.

C. A person who is employed as a clinician or instructor and who engages in the practice of the profession of optometry in this state must be licensed by the board. END_STATUTE

Sec. 10. Section 32-1742, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1742. Registering with board; public registry file; current information

A. Each licensee shall provide the board in writing the addresses of all permanent and extended temporary locations in which the licensee practices and the licensee's office telephone numbers, mailing address and residence address. Any notice required to be given by the board to a licensee shall be sent by mail or email to the licensee's most current mailing or email address shown on the records of the board. The board may attempt to give or serve notice at any other address or location on file with the board if service to the mailing or email address is unsuccessful. Service of a required notice is complete on the date of mailing to the licensee's mailing address or email address.

B. The board shall maintain a current registry of each licensee's name, office locations, and mailing address and email address. The registry is open to the public.

C. Each licensee shall give written notice to the board within ten thirty calendar days following each change in the licensee's residence address, mailing address, email address, office location or office telephone number. END_STATUTE

Sec. 11. Section 32-1748, Arizona Revised Statutes, is amended to read:

START_STATUTE32-1748. Reissuance; reinstatement; modification of suspension; definition

A. On written application and for good cause shown, the board may issue a new license to a doctor of optometry whose license has been revoked, or may reissue a license or modify the suspension of any license to practice optometry that has been suspended.

B. A person applying for reinstatement of a revoked license, in addition to the requirements of this section, shall comply with all initial licensing requirements in existence at the time of the application for reinstatement, except those requirements that are inconsistent with this section shall meet the current licensure requirements in this state.

C. The board shall not issue a new license or reissue a license to a doctor of optometry whose license has been revoked until two years after the effective date of the revocation, except that if the revocation is based only on section 32-1743, subsection A, paragraph 1 and the conviction is ultimately reversed on appeal, the board shall enter an order vacating the revocation.

D. For the purposes of this section, "good cause shown" means that the person making application applying for reinstatement or reissuance shall demonstrate through substantial evidence presented to the board that the person is completely rehabilitated with respect to the conduct that was the basis of the revocation or suspension of the license. Demonstration of rehabilitation shall include includes:

1. Evidence that the person has not engaged in any conduct during the revocation or suspension period that, if the person had been licensed during that period, would have constituted a basis for revocation or suspension pursuant to section 32-1743.

2. Evidence that, with respect to any criminal conviction that constituted any part of the basis for the previous revocation or suspension, the person's civil rights have been fully restored pursuant to statute or other applicable recognized judicial or gubernatorial order.

3. Evidence that restitution has been made to any aggrieved party as ordered by a court of competent jurisdiction.

4. Other evidence of rehabilitation the board deems appropriate. END_STATUTE