S 0214 General Bill, By Bryan, Courtney, Ford, Glover, Holland, Jackson, Land, 
Lander, Martin, Matthews, T.W. Mitchell, Patterson, Peeler, Rankin, Reese, 
L.E. Richter, M.T. Rose, Russell, Ryberg, G. Smith, H.S. Stilwell, Thomas, 
Waldrep and Washington

Similar(H 3137)
 A Bill to amend the Code of Laws of South Carolina, 1976, by adding Section
 40-37-106 so as to provide that an optometrist may supply pharmaceutical
 agents to patients to initiate proper treatment; 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 in their licensing authority, certification for
 purchasing, prescribing, and dispensing pharmaceutical agents; to amend
 Section 40-37-105, relating to application of pharmaceutical agents by
 optometrists, so as to provide for their use in diagnosis and treatment; to
 amend Section 40-37-107, relating to referrals of patients by optometrists to
 physicians, so as to allow referrals to any health care provider and to define
 "health care provider"; to amend Section 40-43-150, as amended, relating to
 who may prescribe drugs, so as to include 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 certified to prescribe and dispense these agents for diagnostic and
 therapeutic purposes; and to amend Section 40-43-360, as amended, relating to
 definitions in the Pharmacy Act, so as to include optometrists as a
 "practitioner" for the purpose of defining who may prescribe drugs.

   01/14/93  Senate Introduced and read first time SJ-16
   01/14/93  Senate Referred to Committee on Medical Affairs SJ-16

A BILL

TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 40-37-106 SO AS TO PROVIDE THAT AN OPTOMETRIST MAY SUPPLY PHARMACEUTICAL AGENTS TO PATIENTS TO INITIATE PROPER TREATMENT; 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 IN THEIR LICENSING AUTHORITY, CERTIFICATION FOR PURCHASING, PRESCRIBING, AND DISPENSING PHARMACEUTICAL AGENTS; TO AMEND SECTION 40-37-105, RELATING TO APPLICATION OF PHARMACEUTICAL AGENTS BY OPTOMETRISTS, SO AS TO PROVIDE FOR THEIR USE IN DIAGNOSIS AND TREATMENT; TO AMEND SECTION 40-37-107, RELATING TO REFERRALS OF PATIENTS BY OPTOMETRISTS TO PHYSICIANS, SO AS TO ALLOW REFERRALS TO ANY HEALTH CARE PROVIDER AND TO DEFINE "HEALTH CARE PROVIDER"; TO AMEND SECTION 40-43-150, AS AMENDED, RELATING TO WHO MAY PRESCRIBE DRUGS, SO AS TO INCLUDE 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 CERTIFIED TO PRESCRIBE AND DISPENSE THESE AGENTS FOR DIAGNOSTIC AND THERAPEUTIC PURPOSES; AND TO AMEND SECTION 40-43-360, AS AMENDED, RELATING TO DEFINITIONS IN THE PHARMACY ACT, SO AS TO INCLUDE OPTOMETRISTS 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:

SECTION 1. The 1976 Code is amended by adding:

"Section 40-37-106. (A) An optometrist may not establish a pharmacy in the optometrist's 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 from supplying a patient with pharmaceutical agents to initiate appropriate treatment if the optometrist is certified by the South Carolina Board of Examiner in Optometry to purchase, possess, administer, prescribe, or dispense pharmaceutical agents.

(B) Nothing in this section or in any other provision of law prohibits an optometrist from purchasing, possessing, administering, selling, prescribing, or dispensing contact lenses or contact lens solutions."

SECTION 2. Section 40-37-20 of the 1976 Code is amended to read:

"Section 40-37-20. (A) There is hereby created the South Carolina Board of Examiners in Optometry which shall consist consists of seven members. Five members shall 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 as to of the unfitness of those rejected. If the Governor declines to appoint any of such the nominees so submitted, additional nominees shall must be submitted in the same manner. Vacancies shall must be filled in like manner by appointment by the Governor for the unexpired portion of the term. Two members of the board shall 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 shall may be nominated by any individual, group, or association, and are appointed by the Governor.

(B) The board shall be is responsible for examining applicants for optometric licenses, including certification to purchase, possess, administer, prescribe, or dispense pharmaceutical agents, and for investigating complaints, and for investigating and prosecuting violations of this chapter.

(C) The members of the board shall be 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 any a person is appointed to fill an unexpired term on the board, he the person may be reappointed for two additional four-year terms. The Governor may remove any a member of the board who has been guilty of continued neglect of his board duties or who is found to be incompetent, or for just cause. No member shall may be removed without first giving him the member an opportunity to refute the charges filed against him. He shall the member who must be given a copy of the charges at the time they are filed."

SECTION 3. Section 40-37-105 of the 1976 Code is amended to read:

"Section 40-37-105. A. (A) Nothing contained in this chapter or in any other provision of law prohibits the topical application use of pharmaceutical agents, other than Schedule I and Schedule II controlled substances as defined in Section 44-53-110 Title 44, Chapter 53, Article 3, to the eye for diagnostic and therapeutic 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;

(3) where miotics are used for emergency purposes involving the buildup of pressure within the eyeball, the optometrist shall immediately 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

(4) the South Carolina Board of Examiners in Optometry shall ensure that the quality and quantity of miotics possessed by any optometrist is consistent with the use of miotics only for emergency purposes involving the buildup of pressure within the eyeball.

B. (B) No licensed optometrist may purchase, possess, or administer, prescribe, or dispense any a pharmaceutical agent unless the optometrist has obtained a certificate from the South Carolina Board of Examiners in Optometry certifying that (1) the optometrist has complied with the educational requirements promulgated by the board and (2) the optometrist has passed a pharmaceutical agent examination which must be administered by the board."

SECTION 4. Section 40-37-107 of the 1976 Code is amended to read:

"Section 40-37-107. 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 doctor when the optometric examination of the patient indicates signs or symptoms of disease, which signs or symptoms require medical evaluation or treatment health care provider when additional evaluation or treatment is necessary. For purposes of this section `health care provider' includes, but is not limited to, another optometrist, an optician, ophthalmologist, other medical doctors, or other licensed health professionals who are appropriate to evaluate or treat the presenting condition. The South Carolina Board of Examiners in Optometry shall promulgate regulations for the maintenance of records of referrals by optometrists in accordance with the provisions of this section."

SECTION 5. 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, 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 a licensed medical or osteopathic physician, podiatrist, dentist, 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, 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."

SECTION 6. 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. Licensed pharmacists may sell pharmaceutical agents, other than Schedule I and Schedule II controlled substances as defined in Section 44-53-110 Title 44, Chapter 53, Article 3, to optometrists who are certified by the South Carolina Board of Examiners in Optometry to purchase, possess, and administer, prescribe, and dispense these pharmaceutical agents for the purpose of topically applying the agents to the eye for diagnostic purposes diagnostic or therapeutic purposes in the practice of optometry. In this section, `pharmaceutical agent' means anesthetics, mydriatics, cycloplegics, misotics, dyes, and over-the-counter drugs."

SECTION 7. 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, 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."

SECTION 8. This act takes effect upon approval by the Governor.