Bd of Examiners in Optometry

Repeals the joint formulary advisory committee and removes
reference to "topically applied" pharmaceutical agents.

HOUSE OF REPRESENTATIVES                H.B. NO.           
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  Section 459-1, Hawaii Revised Statutes, is
 2 amended to read as follows:
 3      "459-1 Optometry; practice of, defined.  The practice of
 4 optometry, for the purpose of this chapter, is defined to be:
 5      (1)  The examination, diagnosis, treatment, and management
 6           of diseases and disorders of the human visual system,
 7           the eye, and the eyelids;
 8      (2)  The employment of trial frame or trial lenses, and any
 9           objective or subjective means or methods, other than
10           the use of surgery, including refractive or therapeutic
11           laser surgery, but including the use and prescription
12           of [topically applied] pharmaceutical agents, as
13           established by the board, and the performance of non-
14           invasive diagnostic procedures or ordering of
15           laboratory tests related to the use of [topically
16           applied] pharmaceutical agents for the purpose of
17           examining, diagnosing, treating, and managing visual,
18           muscular, or other diseases and disorders of the human
19           visual system, the eye, and the eyelids; or

Page 2                                                     1934
                                     H.B. NO.           

 1      (3)  The prescribing, fitting, or adaptation of any
 2           ophthalmic lenses, contact lenses, prisms, frames,
 3           mountings, or orthoptic exercises for the correction or
 4           relief of the visual or muscular anomalies of the human
 5           eye.
 6 Superficial foreign bodies may be removed from the human eye and
 7 eyelids, including the removal of corneal superficial foreign
 8 bodies above Bowman's Layer.
 9      Any person who engages in the prescribing of visual
10 training, with or without the use of scientific instruments to
11 train the visual system or other abnormal condition of the eyes,
12 or claims to be able to do so, shall be deemed to be engaged in
13 the practice of optometry and shall first secure and hold an
14 unrevoked and unsuspended license as provided in this chapter;
15 provided that an orthoptist may give visual training, including
16 exercises, under the supervision of a physician or optometrist.
17 The use and prescription of [topically applied] pharmaceutical
18 agents and the removal of superficial foreign bodies from the
19 human eye and eyelid shall be granted to an optometrist licensed
20 under this chapter who has met the requirements under section
21 459-7.
22      If while examining or treating a patient a licensed
23 optometrist finds, by history or examination, any ocular

Page 3                                                     1934
                                     H.B. NO.           

 1 abnormality or any evidence of systemic disease requiring further
 2 diagnosis and possible treatment beyond the scope of practice as
 3 defined in this section, the optometrist shall refer that patient
 4 to an appropriate licensed physician."
 5      SECTION 2.  Section 459-7.4, Hawaii Revised Statutes, is
 6 amended to read as follows:
 7      "[[]459-7.4[]]  Therapeutically certified optometrists;
 8 scope; qualifications[; advisory committee].(a)  The use and
 9 prescription of [topical] therapeutic pharmaceutical agents as
10 established by the [joint formulary advisory committee and
11 adopted by the] board for the treatment and management of
12 conditions of the anterior segment of the human eye, eyelids, and
13 lacrimal system and the non-invasive surface removal of
14 superficial foreign bodies from the anterior segment of the human
15 eye and eyelids is authorized only for an optometrist licensed
16 under this chapter who meets the requirements of a
17 therapeutically certified optometrist as authorized in this
18 section.  [The therapeutically certified optometrist shall not
19 prescribe, dispense, or administer oral pharmaceutical agents
20 except those available without prescription.]  Treatment of
21 glaucoma and performing any invasive surgery shall not be
22 allowed.  Therapeutic pharmaceutical agents shall not include any
23 of the controlled substances enumerated in sections 329-14,

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                                     H.B. NO.           

 1 329-16, 329-18, 329-20, and 329-22.
 2      (b)  The board shall grant recognition as a therapeutically
 3 certified optometrist; provided the optometrist has:
 4      (1)  A current, unencumbered license as an optometrist in
 5           this State;
 6      (2)  Completed a one hundred hour board-approved course in
 7           the treatment and management of ocular diseases;
 8      (3)  Passed the National Board of Examiners in Optometry
 9           Treatment and Management of Ocular Disease examination;
10      (4)  Completed one hundred hours of preceptorship under the
11           supervision of an ophthalmologist.  The supervising
12           ophthalmologist shall certify completion of the one
13           hundred hours of hands-on experience and the competency
14           of the optometrist to prescribe, dispense, and
15           administer therapeutic pharmaceutical agents on a form
16           and format prescribed by the board; provided that the
17           preceptorship shall include training in diagnosis,
18           treatment, and management of ocular disease; and
19      (5)  The therapeutically certified optometrist shall renew
20           the certification with the biennial renewal of license
21           and submit proof of satisfying thirty-six hours of
22           continuing education in the diagnosis, treatment, and
23           management of ocular and systemic diseases.  Completion

Page 5                                                     1934
                                     H.B. NO.           

 1           of the thirty-six hours in the diagnosis, treatment,
 2           and management of ocular and systemic diseases shall
 3           fulfill the continuing education requirements pursuant
 4           to section 459-7 and this section.
 5      [(c)  The department of commerce and consumer affairs shall
 6 establish a joint formulary advisory committee composed of:
 7      (1)  Two persons licensed as optometrists;
 8      (2)  Two persons licensed as pharmacists; and
 9      (3)  Two persons licensed in medicine by the board of
10           medical examiners and board certified in ophthalmology.
11 The joint formulary advisory committee shall recommend the
12 applicable formulary for persons certified under this section.
13 The board of optometry shall adopt the formulary as established
14 by the joint formulary advisory committee in its rules.]"
15      SECTION 3.  Statutory material to be repealed is bracketed.
16 New statutory material is underscored.
17      SECTION 4.  This Act shall take effect upon its approval.
19                              INTRODUCED BY:______________________