The Committee on Labor, Commerce and Industry proposes the following amendment (LC-4103.WAB0005H):

Amend the bill, as and if amended, SECTION 1, by striking Section 40-37-35(E)(1) and inserting:

 (E)(1) An optometrist who holds a restricted volunteer license issued pursuant to this section is subject to the provisions of this chapter and regulations promulgated pursuant to this chapter except as otherwise provided in this section; however, they may obtain certifications as required by this chapter.

Amend the bill further, SECTION 2, by striking Section 40-37-10(A) and inserting:

 (A) There is created the South Carolina Board of Examiners in Optometry, which consists of seven members. Five members must be licensed optometrists appointed by the Governor upon nomination by all licensed optometrists in this State through an election conducted by the board. The licensed optometrists eligible for election must be in good standing with the South Carolina Board of Examiners in Optometry, must actively be engaged in the delivery of clinical care to patients in South Carolina, must possess proof of proficiency to engage in the full scope of practice of optometry as determined by the board, and must have been engaged in the practice of optometry for at least five years. The Governor may reject any or all of those nominated upon satisfactory showing of the unfitness of those rejected. If the Governor declines to appoint any of the nominees submitted, additional nominees must be submitted in the same manner as the initial nominees. Vacancies must be filled in the manner of the original appointment for the unexpired portion of the term. Two members of the board must be members of the general public who do not derive their income or support from any optical or opticalophthalmic-related business and who are not related to an optometrist or a person engaged in an opticalophthalmic-related business. The members from the general public may be nominated by any individual, group, or association and must be appointed by the Governor in accordance with Chapter 1 of ,Title 40.

Amend the bill further, SECTION 3, by striking Section 40-37-20(3)(c), (d), and (e) and inserting:

  (c) prescribing or using diagnostic and therapeutic pharmaceutical agents delivered by topical and oral route means of administration;any route of administration; and
  (d) performing ophthalmic surgery, as authorized in this section; and
  (e)(d) performing in-office diagnostic testing or ordering appropriate diagnostic lab or imaging tests for conditions that may cause ocular abnormalities.

Amend the bill further, SECTION 3, by striking Section 40-37-20(4), (5), (6), and (7) and inserting:

 (4) "Ophthalmic surgery" means a procedure upon the human eye and adjacent and associated structures in which in vivo tissue is injected, cut, burned, frozen, sutured, epilated, vaporized, coagulated, or photodisrupted by the use of surgical instrumentation such as, but not limited to, a scalpel, cryoprobe, laser, electric cautery, or ionizing radiation. Surgical procedures not involving the eye and its adjacent and associated structures are not part of the practice of optometry. The practice of optometry includes the correction and relief of ocular abnormalities by ophthalmic surgical procedures, subject to the exclusions below. The following procedures are excluded from the scope of practice of optometry, except for the preoperative and postoperative care in connection with these procedures:
  (a) retinal laser procedures;
  (b) penetrating keratoplasty or corneal transplant of any kind;
  (c) injection into the vitreous of the eye to treat any macular or retinal disease;
  (d) the administration of general, regional, or MAC anesthesia;
  (e) LASIK;
  (f) corneal implants;
  (g) surgery related to removal of the eye from a living human being;
  (h) surgery requiring full thickness incision or excision of the cornea or sclera;
  (i) surgery requiring incision of the iris and ciliary body, including iris diathermy or cryotherapy;
  (j) vitrectomy;
  (k) retinal surgery;
  (l) surgical extraction of the intraocular or crystalline lens;
  (m) surgical implantation of an intraocular lens;
  (n) incisional or excisional surgery of the extraocular muscles;
  (o) surgery of the eyelid for confirmed malignancies or for incisional mechanical repair;
  (p) surgery of the bony orbit, including orbital implants;
  (q) incisional or excisional surgery of the lacrimal system; and
  (r) surgery requiring full thickness conjunctivoplasty with graft or flap.
 (2)(5)(4) "Contact lens" means any device placed in contact with the eye for the purpose of correcting vision, therapy, medicinal delivery, or cosmetic alteration;.
  (6)(5) "Vision therapy" means a sequence of neurosensory and neuromuscular activities individually prescribed and monitored by a doctor to develop, rehabilitate and enhance visual skills and processing based on the results of a comprehensive eye examination or consultation. The use of lenses, prisms, filters, occluders, specialized instruments, and computer programs is an integral part of vision therapy. Vision therapy is used to treat ocular motility dysfunctions, non-strabismic binocular disorders, strabismus, amblyopia, accommodative disorders, visual information processing disorders, and visual sequelae of acquired brain injury.
 (3)(7)(6) "Direct supervision" means supervision provided by a licensed optometrist who must:
  (a) be present in the department or facility where the supervisee is performing services;
  (b) be immediately available to assist the supervisee in the services being performed; and
  (c) maintain continued involvement in appropriate aspects of each treatment;.

Amend the bill further, SECTION 3, by striking Section 40-37-20(7), (10), and (11) and inserting:

 (7) "Therapeutic certified optometrist" means an optometrist educated and trained in the use of pharmacological agents for diagnostic and therapeutic purposes and licensed to practice optometry with the use of pharmacological agents for diagnostic and therapeutic purposes.
 (8)(9)(7) "Operator" means the licensed optometrist, optometric practice, or organization engaged in providing optometric services directly or through persons authorized by law to provide the services.
 (10)(8) "Vision screening" means a test or tests used for the intent of detecting potential abnormalities of vision. Vision screenings are also known as vision tests or eye tests. Vision screenings are not synonymous with an eye exam as defined in Section 40-24-10. Vision screenings do not result in a diagnosis, treatment, prescription for medication, or prescription for any adapting lenses, contact lenses, spectacles, eyeglasses, prism, or ocular devices. Abnormal findings resulting from a vision screening should result in a referral to a licensed optometrist or a physician licensed pursuant to Chapter 47, Title 40.
 (9)(11)(9) "Community foundation" means an organization, lawfully organized and in good standing, that typically focuses on supporting a geographical area by addressing community needs and supporting local nonprofits.

Amend the bill further, by deleting SECTION 6 from the bill.

Amend the bill further, SECTION 7, Section 40-37-290, by striking the MACROBUTTON NoMacro <> undesignated paragraph and inserting:

 Section 40-37-290. Notwithstanding any other provision of law, an optometrist may purchase, possess, administer, supply, and prescribe, dispense, and sell pharmaceutical agents, including oral and topically applied medications other than Schedule I and II controlled substances as defined in Section 44-53-110 except controlled substances that have been reclassified from Schedule III to Schedule II effective on or after October 6, 2014, may continue to be purchased, possessed, administered, supplied, and prescribed, and dispensed by an optometrist, for diagnostic and therapeutic purposes in the practice of optometry. Furthermore, an optometrist may dispense and sell topical antibiotics and medicinal delivery contact lenses. An optometrist only may purchase, possess, administer, prescribe, dispense, and sell these medications for vision correction and the treatment of ocular and ocular adnexal eye disease., except that:

Amend the bill further, SECTION 7, by striking Section 40-37-290(2) and inserting:

 (2) when prescribing medications for the treatment of ocular and ocular adnexal disease, documentation in the patient's chart and appropriate consultations and referrals must be in accordance with the standard of care provided for in Section 40-37-310(E);
 (3)(1) when prescribing analgesics, the prescription must be limited to a seven-day supply;
 (4)(2) when prescribing topical steroids, if after twenty-one days of treatment it is necessary to continue this medication, the optometrist shall communicate and collaborate with an ophthalmologist;
 (5)(3) no medications may be given by injection or intravenously.

Amend the bill further, SECTION 8, by striking Section 40-37-310(C) and (D) and inserting:

 (D)(C) An optometrist may perform ophthalmic surgery, as defined in this chapter.is prohibited from performing surgery. For purposes of this section surgery includes, but is not limited to, an invasive procedure using instruments that require closure by suturing, clamping, or other similar devices or a procedure in which the presence or assistance of a nurse anesthetist or an anesthesiologist is required. An optometrist is also prohibited from performing laser surgery. However, nothing in this section or any other provision of law may be construed to prohibit an optometrist from removing superficial ocular and ocular adnexal foreign bodies; removal of other foreign bodies must be referred to an ophthalmologist.
 (E)(D) An optometrist must be held to the same standard of care as persons licensed under Chapter 47, Title 40, Physicians, Surgeons, and Osteopaths, and shall maintain a minimum of one million dollars per claim with a three million dollar aggregate in malpractice insurance coverage.

Amend the bill further, SECTION 10, by striking Section 40-37-420(2)(b)(C) and inserting:

 (C) After September 30, 2008, no person may practice as an optometrist in this State if the person has not met all requirements of this chapter in effect at that time and as may be amended in the future. A basic and diagnostically licensed optometrist who wishes to be recertified after September 30, 2008, shall conform to the licensing requirements for a therapeutically-certified optometrist as provided for in regulation.
 (D) A licensee under this chapter must indicate his or her category of licensure following his or her name or signature on all professional documents.An optometrist licensed to practice optometry prior to January 1, 20262027, may continue to practice under the condition provided for in this section, and regulations promulgated under this chapter. However, an optometrist licensed to practice optometry prior to January 1, 2013, who provides correction and relief of ocular abnormalities by surgical procedures involving surgical adnexa and laser procedures in accordance with this chapter and section 40-37-20 shall fulfill credentialing requirements as established by the board.

Amend the bill further, SECTION 12, by striking Section 44-30-310 and inserting:

 Section 44-30-310. If a health care provider, licensed pursuant to the laws of this State, informs his or her patient in writing, which may include use of an electronic medical record device, before treatment that the treatment to be rendered by thea health carehealthcare provider will be provided free of charge, the health carehealthcare provider is not liable for any civil damages for any personal injury as a result of any act or omission by the health carehealthcare provider rendering treatment free of charge or failure to act to provide or arrange for further treatment, except acts or omission amounting to gross negligence or wilful or wanton misconduct. For purposes of this section, a health carehealthcare provider includes a dentist maintaining a restricted volunteer license pursuant to Section 40-15-177, a practitioner maintaining a special volunteer license pursuant to Section 40-47-34, an optometrist who maintains a special volunteer license pursuant to Section 40-37-35, and a chiropractor maintaining a special volunteer license pursuant to Section 40-9-85.

Amend the bill further, by deleting SECTION 13 from the bill.

Renumber sections to conform.

Amend title to conform.