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H*3137 Session 110 (1993-1994)
H*3137(Rat #0125, Act #0065) General Bill, By B.O. Baker, M.O. Alexander,
Alexander, Allison, Anderson, Askins, Bailey, J.J. Bailey, J.M. Baxley,
D.W. Beatty, Boan, Breeland, H. Brown, J. Brown, A.W. Byrd, Canty, Cato,
C.D. Chamblee, H.H. Clyborne, Cobb-Hunter, Cooper, R.S. Corning, J.L.M. Cromer,
Davenport, Delleney, L.L. Elliott, Fair, T.L. Farr, J.G. Felder, R.C. Fulmer,
Gamble, S.E. Gonzales, Govan, L.O. Graham, H.M. Hallman, Harrell,
J.P. Harrelson, Harrison, Harvin, B.H. Harwell, Haskins, J. Hines, D.N. Holt,
T.E. Huff, H.G. Hutson, Inabinett, M.F. Jaskwhich, Jennings, Keegan, Kelley,
Kennedy, M.H. Kinon, Kirsh, Klauber, Koon, Lanford, Littlejohn, C.V. Marchbanks,
L.M. Martin, J.G. Mattos, J.G. McAbee, McCraw, J.T. McElveen, McKay, McMahand,
D.E. McTeer, Meacham, Moody-Lawrence, J.H. Neal, Neilson, Phillips, Quinn,
Rhoad, Richardson, Robinson, T.F. Rogers, I.K. Rudnick, Scott, Sharpe,
J.S. Shissias, Simrill, R. Smith, D. Smith, J.J. Snow, Spearman, E.C. Stoddard,
C.H. Stone, P.H. Thomas, Townsend, Trotter, J.W. Tucker, Vaughn, C.Y. Waites,
D.C. Waldrop, Walker, C.C. Wells, L.S. Whipper, J.M. White, Wilder, J.B. Wilder,
D. Williams, Witherspoon, S.S. Wofford, H.G. Worley, D.A. Wright,
Young-Brickell and R.M. Young
Similar(S 214)
A Bill to amend the Code of Laws of South Carolina, 1976, by adding Section
40-37-103, so as to provide requirements for diagnostic and therapeutic
certification of an optometrist; by adding Section 40-37-106 so as to prohibit
an optometrist from establishing a pharmacy in an optometry office and to
provide that a certified optometrist may administer or supply pharmaceutical
agents to patients to initiate treatment; by adding Section 40-37-108 so as to
provide that a therapeutically certified optometrist must be held to the
standard of care of physicians and shall maintain one million dollars in
malpractice insurance; to amend Section 40-37-20, relating to the authority
and duties of the South Carolina Board of Examiners in Optometry, so as to
include examining applicants for diagnostic and therapeutic certification; to
amend Section 40-37-105, relating to the use of topical application of
pharmaceutical agents by optometrists, so as to provide for the diagnostic and
the therapeutic use of these agents and to provide restrictions; to amend
Section 40-37-107, relating to referrals of patients by optometrists to
physicians, so as to include referrals to other optometrists under certain
conditions, to provide standards for treating Glaucoma, and to prohibit
surgery; to add Section 40-37-109 so as to define "supply" concerning
pharmaceutical agents; to amend Section 40-37-140, relating to license renewal
and continuing education, so as to require twenty hours of education a year
with certain pharmacological requirements for certified optometrists; to amend
Section 40-43-150, as amended, relating to who may prescribe drugs and to the
sale of drugs at wholesale, so as to include therapeutically certified
optometrists among those who may prescribe and to allow the sale of drugs at
wholesale to diagnostically and therapeutically certified optometrists; to
amend Section 40-43-155, as amended, relating to pharmacists selling
pharmaceutical agents to optometrists, so as to provide that they may be sold
to optometrists who are diagnostically and therapeutically certified
optometrists for certain purposes; and to amend Section 40-43-360, as amended,
relating to definitions in the Pharmacy Act, so as to include a
therapeutically certified optometrist as a "practitioner" for the purpose of
defining who may prescribe drugs.-amended title
01/14/93 House Introduced and read first time HJ-13
01/14/93 House Referred to Committee on Medical, Military,
Public and Municipal Affairs HJ-14
02/03/93 House Committee report: Majority favorable with amend.,
minority unfavorable Medical, Military, Public
and Municipal Affairs HJ-2
02/10/93 House Amended HJ-41
02/10/93 House Read second time HJ-50
02/10/93 House Roll call Yeas-109 HJ-50
02/11/93 House Read third time and sent to Senate HJ-21
02/16/93 Senate Introduced and read first time SJ-3
02/16/93 Senate Referred to Committee on Medical Affairs SJ-4
04/07/93 Senate Committee report: Favorable with amendment
Medical Affairs SJ-27
04/20/93 Senate Amended SJ-38
04/20/93 Senate Read second time SJ-39
04/20/93 Senate Ordered to third reading with notice of
amendments SJ-39
04/22/93 Senate Special order SJ-29
04/28/93 Senate Debate interrupted SJ-42
04/29/93 Senate Read third time and returned to House with
amendments SJ-42
05/05/93 House Senate amendment amended HJ-39
05/05/93 House Returned to Senate with amendments HJ-39
05/05/93 Senate Concurred in House amendment and enrolled SJ-7
05/11/93 Ratified R 125
05/14/93 Signed By Governor
05/14/93 Effective date 05/14/93
05/26/93 Copies available
(A65, R125, H3137)
AN ACT TO AMEND THE CODE OF LAWS OF SOUTH
CAROLINA, 1976, BY ADDING SECTION 40-37-103 SO AS TO
PROVIDE REQUIREMENTS FOR DIAGNOSTIC AND THERAPEUTIC
CERTIFICATION OF AN OPTOMETRIST; BY ADDING SECTION
40-37-106 SO AS TO PROHIBIT AN OPTOMETRIST FROM
ESTABLISHING A PHARMACY IN AN OPTOMETRY OFFICE AND
TO PROVIDE THAT A CERTIFIED OPTOMETRIST MAY
ADMINISTER OR SUPPLY PHARMACEUTICAL AGENTS TO
PATIENTS TO INITIATE TREATMENT; BY ADDING SECTION
40-37-108 SO AS TO PROVIDE THAT A THERAPEUTICALLY
CERTIFIED OPTOMETRIST MUST BE HELD TO THE STANDARD
OF CARE OF PHYSICIANS AND SHALL MAINTAIN ONE MILLION
DOLLARS IN MALPRACTICE INSURANCE; TO AMEND SECTION
40-37-20, RELATING TO THE AUTHORITY AND DUTIES OF THE
SOUTH CAROLINA BOARD OF EXAMINERS IN OPTOMETRY, SO
AS TO INCLUDE EXAMINING APPLICANTS FOR DIAGNOSTIC
AND THERAPEUTIC CERTIFICATION; TO AMEND SECTION
40-37-105, RELATING TO THE USE OF TOPICAL APPLICATION OF
PHARMACEUTICAL AGENTS BY OPTOMETRISTS, SO AS TO
PROVIDE FOR THE DIAGNOSTIC AND THE THERAPEUTIC USE OF
THESE AGENTS AND TO PROVIDE RESTRICTIONS; TO AMEND
SECTION 40-37-107, RELATING TO REFERRALS OF PATIENTS BY
OPTOMETRISTS TO PHYSICIANS, SO AS TO INCLUDE
REFERRALS TO OTHER OPTOMETRISTS UNDER CERTAIN
CONDITIONS, TO PROVIDE STANDARDS FOR TREATING
GLAUCOMA, AND TO PROHIBIT SURGERY; TO ADD SECTION
40-37-109 SO AS TO DEFINE "SUPPLY" CONCERNING
PHARMACEUTICAL AGENTS; TO AMEND SECTION 40-37-140,
RELATING TO LICENSE RENEWAL AND CONTINUING
EDUCATION, SO AS TO REQUIRE TWENTY HOURS OF
EDUCATION A YEAR WITH CERTAIN PHARMACOLOGICAL
REQUIREMENTS FOR CERTIFIED OPTOMETRISTS; TO AMEND
SECTION 40-43-150, AS AMENDED, RELATING TO WHO MAY
PRESCRIBE DRUGS AND TO THE SALE OF DRUGS AT
WHOLESALE, SO AS TO INCLUDE THERAPEUTICALLY
CERTIFIED OPTOMETRISTS AMONG THOSE WHO MAY
PRESCRIBE AND TO ALLOW THE SALE OF DRUGS AT
WHOLESALE TO DIAGNOSTICALLY AND THERAPEUTICALLY
CERTIFIED OPTOMETRISTS; TO AMEND SECTION 40-43-155, AS
AMENDED, RELATING TO PHARMACISTS SELLING
PHARMACEUTICAL AGENTS TO OPTOMETRISTS, SO AS TO
PROVIDE THAT THEY MAY BE SOLD TO OPTOMETRISTS WHO
ARE DIAGNOSTICALLY AND THERAPEUTICALLY CERTIFIED
OPTOMETRISTS FOR CERTAIN PURPOSES; AND TO AMEND
SECTION 40-43-360, AS AMENDED, RELATING TO DEFINITIONS IN
THE PHARMACY ACT, SO AS TO INCLUDE A THERAPEUTICALLY
CERTIFIED OPTOMETRIST AS A "PRACTITIONER" FOR
THE PURPOSE OF DEFINING WHO MAY PRESCRIBE
DRUGS.
Be it enacted by the General Assembly of the State of South Carolina:
Requirements for diagnostic and therapeutic certification
SECTION 1. The 1976 Code is amended by adding:
"Section 40-37-103. (A) The board shall certify a licensed
optometrist as a diagnostically certified optometrist if the optometrist
has:
(1) complied with the educational requirements promulgated by the
board; and
(2) passed a pharmaceutical agent examination which must be
administered by the board.
(B) The board shall certify a licensed optometrist as a therapeutically
certified optometrist if the optometrist has:
(1) satisfied the requirements for diagnostic certification;
(2) passed the Treatment and Management of Ocular Disease
Examination administered by the National Board of Examiners in
Optometry; and
(3) taken at least one hundred ten hours of board-approved optometric
education courses since December 31, 1988, and after graduation from
optometry school, of which at least forty hours must have been clinical
instruction specifically related to the diagnosis and treatment of glaucoma
and must have been taken under the supervision of an ophthalmologist who
must submit a written certification to the Board of Examiners in Optometry
that the optometrist has completed the forty hours of clinical instruction
required by this item.
(4) submitted to the board an affidavit stating that the optometrist has
had at least twelve hundred hours of clinical training."
Pharmacy may not be established by optometrist
SECTION 2. The 1976 Code is amended by adding:
"Section 40-37-106. (A) An optometrist may not establish a
pharmacy in an optometry office or sell pharmaceutical agents prescribed in
treatment unless there is a licensed pharmacist on staff and present when
these prescriptions are filled. However, nothing in this section or in any
other provision of law prohibits an optometrist who is diagnostically
certified from administering pharmaceutical agents to a patient or an
optometrist who is therapeutically certified from administering or supplying
pharmaceutical agents to a patient, without charge for the pharmaceutical
agents, to initiate appropriate treatment.
(B) Notwithstanding subsection (A) or any other provision of law, an
optometrist may purchase, possess, administer, sell, prescribe, or dispense
contact lenses, contact lens solutions, and topically applied dyes."
Standard of care and malpractice insurance for diagnostically certified
optometrists
SECTION 3. The 1976 Code is amended by adding:
"Section 40-37-108. A therapeutically certified optometrist must
be held to the same standard of care as persons licensed under Title 40,
Chapter 47, Physicians, Surgeons and Osteopaths and shall maintain a
minimum of one million dollars in malpractice insurance
coverage."
Board powers and duties issuance of certifications
SECTION 4. Section 40-37-20 of the 1976 Code is amended to read:
"Section 40-37-20. (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 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. Vacancies must be filled
in like manner by appointment by the Governor 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
related business or who are not related to any members of these
professions. These public members may be nominated by any individual,
group, or association, and are appointed by the Governor.
(B) The board is responsible for examining applicants for optometric
licenses and for diagnostic and therapeutic certifications, for investigating
complaints, and for investigating and prosecuting violations of this
chapter.
(C) The members of the board are appointed for terms of four years and
until their successors are appointed and qualify. No person may serve more
than two consecutive four-year terms on the board, except that if a person is
appointed to fill an unexpired term on the board, the person may be
reappointed for two additional four-year terms. The Governor may remove
a member of the board who has been guilty of continued neglect of board
duties or who is found to be incompetent or for just cause. No member may
be removed without first giving the member an opportunity to refute the
charges filed against the member, who must be given a copy of the charges
at the time they are filed."
Authority of optometrist to use and prescribe pharmaceutical
agents
SECTION 5. Section 40-37-105 of the 1976 Code is amended to read:
"Section 40-37-105. (A) Notwithstanding any other provision
of law, a diagnostically certified optometrist may purchase, possess, and
administer pharmaceutical agents, including pharmaceutical agents for
topical application, other than controlled substances as defined in Section
44-53-110, for diagnostic purposes in the practice of optometry. For the
purposes of this section, `pharmaceutical agent' means: anesthetics,
mydriatics, cycloplegics, miotics, dyes, and over-the-counter drugs. Miotics
may be used only pursuant to the following restrictions:
(1) miotics may not be used for treatment purposes;
(2) miotics may be used only for emergency purposes involving the
buildup of pressure within the eyeball and immediately upon this
emergency use the optometrist shall refer the patient to an ophthalmologist
and file with the South Carolina Board of Examiners in Optometry a
written report of the incident in the manner prescribed by the board by
regulation; and
(3) the South Carolina Board of Examiners in Optometry shall ensure
that the quality and quantity of miotics possessed by a diagnostically
certified optometrist is consistent with the use of miotics only for
emergency purposes involving the buildup of pressure within the
eyeball.
(B) Notwithstanding any other provision of law, a therapeutically
certified optometrist may purchase, possess, administer, supply, and
prescribe pharmaceutical agents, other than Schedule I and II controlled
substances as defined in Section 44-53-110, for diagnostic and therapeutic
purposes in the practice of optometry, except that:
(1) when prescribing oral medications a therapeutically certified
optometrist is limited to these oral pharmaceutical agents: antihistamines,
antimicrobial, antiglaucoma, over-the-counter drugs, and analgesics and
may only prescribe these pharmaceutical agents for the treatment of ocular
and ocular adnexal eye disease;
(2) when prescribing oral pharmaceutical agents, documentation
must be made in the patient's chart;
(3) when prescribing analgesics, the prescription must be limited to a
seven-day supply;
(4) when prescribing topical steroids, if after ten days of treatment it
is necessary to continue this medication, the optometrist shall communicate
and collaborate with an ophthalmologist, and if after twenty-one days of
treatment it is necessary to continue this medication, the optometrist must
refer the patient to an ophthalmologist;
(5) when treating glaucoma using beta blocking pharmaceutical
agents, a therapeutically certified optometrist must consult personally with
or refer to a family practitioner, general practitioner, internist, or other
appropriate physician;
(6) no medications may be given by injection or
intravenously."
Authority to diagnose and treatment; requirement to refer; surgery
prohibited
SECTION 6. Section 40-37-107 of the 1976 Code is amended to read:
"Section 40-37-107. (A) In the diagnosis or treatment of eye
disease an optometrist, using judgment and that degree of skill, care,
knowledge, and attention ordinarily possessed and exercised by
optometrists in good standing under like circumstances, shall refer a patient
to an appropriate medical or osteopathic doctor including, but not limited
to, corneal, glaucoma, or retinal opthamological specialists when additional
evaluation or treatment is necessary. However, an optometrist who is not
therapeutically certified may refer a patient to a therapeutically certified
optometrist when additional evaluation or treatment is necessary or to a
medical or osteopathic doctor as provided for in this section, and any
optometrist may refer a patient to another optometrist for the purpose of
fitting or dispensing eye glasses, contact lenses, or low vision aids. The
South Carolina Board of Examiners in Optometry shall promulgate
regulations for the maintenance of records of referrals by optometrists in
accordance with this section.
(B) Notwithstanding subsection (A) in treating and managing glaucoma,
a therapeutically certified optometrist must strive to achieve a stable range
of intraocular pressures considered unlikely to cause further optic nerve
damage in that patient. Once this range of pressures is selected based on
conditions presented by the patient, the therapeutically certified optometrist
must enter this range in the patient's chart. If no progress is achieved in
realizing the selected range of pressures within sixty days of initiating
treatment, the optometrist shall refer the patient to an ophthalmologist.
However, when treating acute angle closure glaucoma, a therapeutically
certified optometrist shall immediately initiate treatment and make an
appropriate referral to an ophthalmologist.
(C) An optometrist is prohibited from performing surgery. For purposes
of this subsection surgery includes, but is not limited to, an invasive
procedure using instruments which requires 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. Laser surgery is
prohibited. However, nothing in subsection (A), this subsection, 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."
Definition
SECTION 7. The 1976 Code is amended by adding:
"Section 40-37-109. For purposes of this chapter `supply' is
limited to pharmaceutical agents given to a patient by a
therapeutically-certified optometrist for the purpose of initiating treatment
until the patient's prescription can be filled by a registered
pharmacist."
License renewal and continuing education
SECTION 8. Section 40-37-140 of the 1976 Code is amended to read:
"Section 40-37-140. (a) An optometrist practicing in this State
who desires to continue to be licensed annually shall pay before the second
day of October of each year a renewal fee to be fixed by regulation. In case
of default in making this payment the license of an optometrist is
automatically terminated provided the board gives the licensee thirty days'
notice in writing before the imposition of the mandatory termination. The
deposit of this notice in the United States Post Office addressed to the
licensee at the licensee's last current address as registered with the board,
with postage prepaid, is due and legal service of the notice. If within the
thirty-day period the licensee pays a penalty that the board may impose, not
to exceed fifty dollars, and the renewal fee, the license must be renewed. A
person whose license is terminated because of a failure to pay a renewal fee
may apply to have it reinstated upon payment to the board of all renewal
fees that should have been paid had the license remained active and a
penalty of one hundred dollars. If the license has lapsed for more than two
years, the licensee shall appear before the board who shall then determine
whether or upon what conditions the license may be reinstated.
(B) An optometrist annually shall attend a minimum of twenty hours
of continuing educational courses or meetings. The instruction must be on
subjects relative to optometry, exclusive of office management or
administration, at board-approved and recognized educational seminars and
courses or accredited institutions of learning. For optometrists
diagnostically or therapeutically certified, eight of the twenty hours must be
pharmacology related. Satisfactory proof of compliance with this
requirement is a prerequisite for annual license renewal."
Professionals authorized to prescribe
SECTION 9. Section 40-43-150 of the 1976 Code, as last amended by Act
303 of 1992, is further amended to read:
"Section 40-43-150. (A) It is unlawful for a person to sell, give
away, barter, exchange, distribute, or possess in the State, except on a
prescription of a licensed medical or osteopathic physician, podiatrist,
dentist, therapeutically certified optometrist, nurse practitioner, or
veterinarian a drug bearing on its manufacturer's or distributor's original
commercial container the legend, `CAUTION: Federal law prohibits
dispensing without a prescription' and those which, in the discretion of the
Board of Pharmacy, are classified as `dangerous drugs' within the meaning
of this section.
(B) The prescription must be compounded only by a licensed
pharmacist, licensed assistant pharmacist, or under the direct personal
supervision of a licensed pharmacist. No prescription may be refilled
except upon the authorization of the licensed medical or osteopathic
physician, podiatrist, dentist, therapeutically certified optometrist, nurse
practitioner, or veterinarian who prescribed it.
(C) This section does not apply to the sale at wholesale by recognized
drug jobbers or wholesalers or drug manufacturers to pharmacists or drug
outlets or licensed medical or osteopathic physicians, podiatrists, dentists,
diagnostically or therapeutically certified optometrists, or veterinarians
qualified to practice their professions according to the laws of this State,
nor to the sale by pharmacists in drug outlets to one another. This section
applies to the sale by a manufacturer, wholesaler, or retailer to a person
other than those legally qualified and authorized to purchase and hold them
for resale in this State."
Sale of pharmaceutical agents
SECTION 10. Section 40-43-155 of the 1976 Code, as last amended by
Act 548 of 1988, is further amended to read:
"Section 40-43-155. (A) Licensed pharmacists may sell
pharmaceutical agents, other than controlled substances as defined in
Section 44-53-110, to optometrists who are diagnostically certified by the
South Carolina Board of Examiners in Optometry for diagnostic purposes
in the practice of optometry in accordance with Section 40-37-105(A). In
this subsection, `pharmaceutical agent' means anesthetics, mydriatics,
cycloplegics, miotics, dyes, and over-the-counter drugs.
(B) Licensed pharmacists may sell pharmaceutical agents, other than
Schedule I and Schedule II controlled substances as defined in Section
44-53-110, to optometrists who are therapeutically certified by the South
Carolina Board of Examiners in Optometry for diagnostic and therapeutic
purposes in the practice of optometry in accordance with Section
40-37-105(B)."
Definition
SECTION 11. The third paragraph of Section 40-43-360 of the 1976
Code, as last amended by Act 303 of 1992, is further amended to read:
"`Pharmacy' means an outlet dispensing drugs on the order of a
practitioner licensed to prescribe drugs. `Practitioner' means a physician,
dentist, osteopath, podiatrist, therapeutically certified optometrist, nurse
practitioner, or veterinarian licensed by any state or territory, other than
pharmacists engaged in the practice of pharmacy, to prescribe with regard
to drugs or devices in the course of professional practice or research.
Nothing in this section supersedes the Nursing Dispensing Act."
Time effective
SECTION 12. This act takes effect upon approval by the Governor.
Approved the 14th day of May, 1993. |
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