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       Florida Senate - 2010                                     SB 330
       By Senator Bennett
       21-00386-10                                            2010330__
    1                        A bill to be entitled                      
    2         An act relating to the practice of optometry; amending
    3         s. 463.002, F.S.; revising terminology to conform to
    4         changes made by the act; amending s. 463.005, F.S.;
    5         authorizing the Board of Optometry to adopt rules for
    6         the administration and prescription of oral ocular
    7         pharmaceutical agents; amending s. 463.0055, F.S.;
    8         authorizing certified optometrists to administer and
    9         prescribe oral ocular pharmaceutical agents under
   10         certain circumstances; revising requirements for the
   11         certified optometrist formulary of ocular
   12         pharmaceutical agents; revising qualifications of
   13         certain members of the formulary committee;
   14         prohibiting the committee from reviewing requests or
   15         issuing advisory opinions or recommendations regarding
   16         oral ocular pharmaceutical agents; requiring the
   17         formulary to include certain oral ocular
   18         pharmaceutical agents; prohibiting the board from
   19         adding to, deleting from, or modifying the formulary
   20         with respect to oral ocular pharmaceutical agents;
   21         amending ss. 463.0057 and 463.006, F.S.; conforming
   22         provisions to changes made by the act; amending s.
   23         893.02, F.S.; revising a definition to specify that
   24         certified optometrists are practitioners for purposes
   25         of the Florida Comprehensive Drug Abuse Prevention and
   26         Control Act; amending s. 893.05, F.S.; prohibiting
   27         certified optometrists from administering and
   28         prescribing certain controlled substances; providing
   29         an effective date.
   31  Be It Enacted by the Legislature of the State of Florida:
   33         Section 1. Subsections (3), (4), and (5) of section
   34  463.002, Florida Statutes, are amended to read:
   35         463.002 Definitions.—As used in this chapter, the term:
   36         (3)(a) “Licensed practitioner” means a person who is a
   37  primary health care provider licensed to engage in the practice
   38  of optometry under the authority of this chapter.
   39         (b) A licensed practitioner who is not a certified
   40  optometrist shall be required to display at her or his place of
   41  practice a sign which states, “I am a Licensed Practitioner, not
   42  a Certified Optometrist, and I am not able to prescribe topical
   43  or oral ocular pharmaceutical agents.”
   44         (c) All practitioners initially licensed after July 1,
   45  1993, must be certified optometrists.
   46         (4) “Certified optometrist” means a licensed practitioner
   47  authorized by the board to administer and prescribe topical and
   48  oral ocular pharmaceutical agents.
   49         (5) “Optometry” means the diagnosis of conditions of the
   50  human eye and its appendages; the employment of any objective or
   51  subjective means or methods, including the administration of
   52  topical and oral ocular pharmaceutical agents, for the purpose
   53  of determining the refractive powers of the human eyes, or any
   54  visual, muscular, neurological, or anatomic anomalies of the
   55  human eyes and their appendages; and the prescribing and
   56  employment of lenses, prisms, frames, mountings, contact lenses,
   57  orthoptic exercises, light frequencies, and any other means or
   58  methods, including topical and oral ocular pharmaceutical
   59  agents, for the correction, remedy, or relief of any
   60  insufficiencies or abnormal conditions of the human eyes and
   61  their appendages.
   62         Section 2. Paragraph (g) of subsection (1) of section
   63  463.005, Florida Statutes, is amended to read:
   64         463.005 Authority of the board.—
   65         (1) The Board of Optometry has authority to adopt rules
   66  pursuant to ss. 120.536 (1) and 120.54 to implement the
   67  provisions of this chapter conferring duties upon it. Such rules
   68  shall include, but not be limited to, rules relating to:
   69         (g) Administration and prescription of topical and oral
   70  ocular pharmaceutical agents.
   71         Section 3. Section 463.0055, Florida Statutes, is amended
   72  to read:
   73         463.0055 Administration and prescription of topical and
   74  oral ocular pharmaceutical agents; committee.—
   75         (1) Certified optometrists may administer and prescribe
   76  topical and oral ocular pharmaceutical agents as provided in
   77  this section for the diagnosis and treatment of ocular
   78  conditions of the human eye and its appendages without the use
   79  of surgery or other invasive techniques. However, a licensed
   80  practitioner who is not certified may use topically applied
   81  anesthetics solely for the purpose of glaucoma examinations, but
   82  is otherwise prohibited from administering or prescribing
   83  topical or oral ocular pharmaceutical agents.
   84         (2)(a) There is hereby created a committee composed of two
   85  certified optometrists licensed pursuant to this chapter,
   86  appointed by the Board of Optometry, two board-certified
   87  ophthalmologists licensed pursuant to chapter 458 or chapter
   88  459, appointed by the Board of Medicine, and one additional
   89  person with a doctorate degree in pharmacology who is not
   90  licensed pursuant to chapter 458, chapter 459, or this chapter,
   91  appointed by the State Surgeon General. The committee shall
   92  review requests for additions to, deletions from, or
   93  modifications of a formulary of topical ocular pharmaceutical
   94  agents for administration and prescription by certified
   95  optometrists and shall provide to the board advisory opinions
   96  and recommendations on such requests. However, the committee may
   97  not review a request or provide an advisory opinion or
   98  recommendation regarding any oral ocular pharmaceutical agent.
   99         (b) The formulary shall consist of those topical ocular
  100  pharmaceutical agents which the certified optometrist is
  101  qualified to use in the practice of optometry and those topical
  102  ocular pharmaceutical agents appropriate to treat and diagnose
  103  ocular diseases or disorders within the scope of optometric
  104  practice. The formulary shall also include the following oral
  105  ocular pharmaceutical agents:
  106         1. The following analgesics, which may not be administered
  107  or prescribed for more than 72 hours without consultation with a
  108  physician licensed under chapter 458 or chapter 459 who is
  109  skilled in diseases of the eye:
  110         a. Acetaminophen with propoxyphene napsylate.
  111         b. Tramadol hydrochloride.
  112         c. Acetaminophen 300 mg with No. 3 codeine phosphate 30 mg.
  113         2. The following antibiotics:
  114         a. Amoxicillin.
  115         b. Azithromycin.
  116         c. Ciprofloxacin.
  117         d. Dicloxacillin.
  118         e. Doxycycline.
  119         3. The following antivirals:
  120         a. Acyclovir.
  121         b. Famciclovir.
  122         c. Valacyclovir.
  123         4. The following oral anti-glaucoma agents, which may not
  124  be administered or prescribed for more than 72 hours without
  125  consultation with a physician licensed under chapter 458 or
  126  chapter 459 who is skilled in diseases of the eye:
  127         a. Acetazolamide.
  128         b. Methazolamide.
  130  The board shall establish, add to, delete from, or modify the
  131  formulary by rule. However, the board may not add to, delete
  132  from, or modify the formulary with respect to the oral ocular
  133  pharmaceutical agents listed in this paragraph. Notwithstanding
  134  any provision of chapter 120 to the contrary, the formulary rule
  135  shall become effective 60 days from the date it is filed with
  136  the Secretary of State.
  137         (c)(b) The formulary may be added to, deleted from, or
  138  modified according to the procedure described in paragraphs
  139  paragraph (a) and (b). Any person who requests an addition,
  140  deletion, or modification of an authorized topical ocular
  141  pharmaceutical agent has shall have the burden of proof to show
  142  cause why such addition, deletion, or modification should be
  143  made.
  144         (d)(c) The State Surgeon General shall have standing to
  145  challenge any rule or proposed rule of the board pursuant to s.
  146  120.56. In addition to challenges for any invalid exercise of
  147  delegated legislative authority, the administrative law judge,
  148  upon such a challenge by the State Surgeon General, may declare
  149  all or part of a rule or proposed rule invalid if it:
  150         1. Does not protect the public from any significant and
  151  discernible harm or damages;
  152         2. Unreasonably restricts competition or the availability
  153  of professional services in the state or in a significant part
  154  of the state; or
  155         3. Unnecessarily increases the cost of professional
  156  services without a corresponding or equivalent public benefit.
  158  However, there shall not be created a presumption of the
  159  existence of any of the conditions cited in this subsection in
  160  the event that the rule or proposed rule is challenged.
  161         (e)(d) Upon adoption of the formulary required by this
  162  section, and upon each addition, deletion, or modification to
  163  the formulary, the board shall mail a copy of the amended
  164  formulary to each certified optometrist and to each pharmacy
  165  licensed by the state.
  166         (3) A certified optometrist shall be issued a prescriber
  167  number by the board. Any prescription written by a certified
  168  optometrist for a topical or oral ocular pharmaceutical agent
  169  pursuant to this section shall have the prescriber number
  170  printed thereon.
  171         Section 4. Subsection (3) of section 463.0057, Florida
  172  Statutes, is amended to read:
  173         463.0057 Optometric faculty certificate.—
  174         (3) The holder of a faculty certificate may engage in the
  175  practice of optometry as permitted by this section, but may not
  176  administer or prescribe topical or oral ocular pharmaceutical
  177  agents unless the certificateholder has satisfied the
  178  requirements of s. 463.006(1)(b)4. and 5.
  179         Section 5. Subsections (2) and (3) of section 463.006,
  180  Florida Statutes, are amended to read:
  181         463.006 Licensure and certification by examination.—
  182         (2) The examination shall consist of the appropriate
  183  subjects, including applicable state laws and rules and general
  184  and ocular pharmacology with emphasis on the topical
  185  application, oral administration, and side effects of ocular
  186  pharmaceutical agents. The board may by rule substitute a
  187  national examination as part or all of the examination and may
  188  by rule offer a practical examination in addition to the written
  189  examination.
  190         (3) Each applicant who successfully passes the examination
  191  and otherwise meets the requirements of this chapter is entitled
  192  to be licensed as a practitioner and to be certified to
  193  administer and prescribe topical and oral ocular pharmaceutical
  194  agents in the diagnosis and treatment of ocular conditions.
  195         Section 6. Subsection (20) of section 893.02, Florida
  196  Statutes, is amended to read:
  197         893.02 Definitions.—The following words and phrases as used
  198  in this chapter shall have the following meanings, unless the
  199  context otherwise requires:
  200         (20) “Practitioner” means a physician licensed pursuant to
  201  chapter 458, a dentist licensed pursuant to chapter 466, a
  202  veterinarian licensed pursuant to chapter 474, an osteopathic
  203  physician licensed pursuant to chapter 459, a naturopath
  204  licensed pursuant to chapter 462, or a podiatric physician
  205  licensed pursuant to chapter 461, or an optometrist certified
  206  pursuant to chapter 463 to administer and prescribe topical and
  207  oral ocular pharmaceutical agents, if provided such practitioner
  208  holds a valid federal controlled substance registry number.
  209         Section 7. Subsection (1) of section 893.05, Florida
  210  Statutes, is amended to read:
  211         893.05 Practitioners and persons administering controlled
  212  substances in their absence.—
  213         (1) A practitioner, in good faith and in the course of his
  214  or her professional practice only, may prescribe, administer,
  215  dispense, mix, or otherwise prepare a controlled substance, or
  216  the practitioner may cause the same to be administered by a
  217  licensed nurse or an intern practitioner under his or her
  218  direction and supervision only. A veterinarian may so prescribe,
  219  administer, dispense, mix, or prepare a controlled substance for
  220  use on animals only, and may cause it to be administered by an
  221  assistant or orderly under the veterinarian’s direction and
  222  supervision only. An optometrist certified pursuant to chapter
  223  463 to administer and prescribe topical and oral ocular
  224  pharmaceutical agents may not administer or prescribe any
  225  controlled substance listed on Schedule I or Schedule II of s.
  226  893.03.
  227         Section 8. This act shall take effect July 1, 2010.

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