Bill Summary – FastDemocracy

LEGISLATIVE GENERAL COUNSEL                                            S.B. 210
Approved for Filing: C. Williams 6                           1st Sub. (Green)
          6 02-24-24 7:04 PM 6
                         Senator Curtis S. Bramble proposes the following substitute bill:
                        OPTOMETRIST PRACTICE AMENDMENTS
                                       2024 GENERAL SESSION
                                            STATE OF UTAH
                                Chief Sponsor: Curtis S. Bramble
                                House Sponsor: James A. Dunnigan
 6
 LONG TITLE
 General Description:
        This bill allows an optometrist to perform certain laser procedures.
 Highlighted Provisions:
        This bill:
        < creates a certification for an optometrist to perform a certain laser procedure;
        < requires an optometrist to obtain training to obtain the certification;
        < requires a certified optometrist to comply with reporting requirements and other
 standards;
        < requires the Office of Professional Licensure Review to make a recommendation
 after reviewing outcome data on whether optometrists should continue performing
 the laser procedure; and
        < creates a sunset date.
 Money Appropriated in this Bill:                                                            1st Sub. S.B. 210
        None
 Other Special Clauses:
        None
 Utah Code Sections Affected:
 AMENDS:
     *SB0210S01*
       1st Sub. (Green) S.B. 210                                                  02-24-24 7:04 PM
        58-16a-102, as last amended by Laws of Utah 2020, Chapter 339
        58-16a-501, as last amended by Laws of Utah 2020, Chapter 339
        58-16a-502, as last amended by Laws of Utah 2020, Chapter 25
        58-16a-601, as last amended by Laws of Utah 2017, Chapter 292
        58-67-201, as last amended by Laws of Utah 2022, Chapter 284
        63I-1-258, as last amended by Laws of Utah 2023, Chapter 303
 ENACTS:
        58-16a-602, Utah Code Annotated 1953
34
 Be it enacted by the Legislature of the state of Utah:
        Section 1. Section 58-16a-102 is amended to read:
        58-16a-102. Definitions.
        In addition to the definitions in Section 58-1-102, as used in this chapter:
        (1) "Board" means the Optometrist Licensing Board created in Section 58-16a-201.
        (2) "Contact lens" means any lens that:
        (a) has a spherical, cylindrical, or prismatic power or curvature;
        (b) is made pursuant to a current prescription; and
        (c) is intended to be worn on the surface of the eye.
        (3) (a) "Contact lens prescription" means a written or verbal order for contact lenses
 that includes:
        (i) the commencement date of the prescription;
        (ii) the base curve, power, diameter, material or brand name, and expiration date;
        (iii) for a written order, the signature of the prescribing optometrist or physician; and
        (iv) for a verbal order, a record maintained by the recipient of:
        (A) the name of the prescribing optometrist or physician; and
        (B) the date when the prescription was issued or ordered.
        (b) A prescription may include:
        (i) a limit on the quantity of lenses that may be ordered under the prescription if
 required for medical reasons documented in the patient's files; and
        (ii) the expiration date of the prescription, which shall be two years from the
 commencement date, unless documented medical reasons require otherwise.
                                                     -2-
       02-24-24 7:04 PM                                                     1st Sub. (Green) S.B. 210
        (c) When a provider prescribes a private label contact lens for a patient the prescription
 shall include:
        (i) the name of the manufacturer;
        (ii) the trade name of the private label brand; and
        (iii) if applicable, the trade name of the equivalent national brand.
        (4) "Contact lens prescription verification" means a written request from a person who
 sells or provides contact lenses that:
        (a) is sent to the prescribing optometrist or physician; and
        (b) seeks the confirmation of the accuracy of a patient's prescription.
        (5) "Eye and its adnexa" means the human eye and all structures situated within the
 orbit, including the conjunctiva, lids, lashes, and lacrimal system.
        (6) "Fitting of a contact lens" means:
        (a) the using of a keratometer to measure the human eye;
        (b) utilizing refractive data provided by a licensed optometrist or ophthalmologist; and
        (c) trial fitting of contact lenses, which includes a period of time for evaluation for fit
 and performance, to determine a tentative contact lens prescription for a patient if the patient:
        (i) has not worn contact lenses before; or
        (ii) has changed to a different type or base curve.
        (7) "Laser surgery" means surgery in which human tissue is cut, burned, or vaporized
 by means of laser or ionizing radiation.
        (8) "Ophthalmic lens" means any lens used to treat the eye and that:
        (a) has a spherical, cylindrical, or prismatic power;
        (b) is made pursuant to an unexpired prescription; and
        (c) is intended to be used in eyeglasses or spectacles.
        (9) "Optometric assistant" means an unlicensed individual:
        (a) working under the direct and immediate supervision of a licensed optometrist; and
        (b) engaged in specific tasks assigned by the licensed optometrist in accordance with
 the standards and ethics of the profession.
        (10) "Optometrist" or "optometric physician" means an individual licensed under this
 chapter.
        (11) "Optometry" and "practice of optometry" mean any one or any combination of the
                                                     -3-
        1st Sub. (Green) S.B. 210                                                   02-24-24 7:04 PM
 following practices:
         (a) examination of the human eye and its adnexa to detect and diagnose defects or
 abnormal conditions;
         (b) determination or modification of the accommodative or refractive state of the
 human eye or its range or power of vision by administration and prescription of pharmaceutical
 agents or the use of diagnostic instruments;
         (c) prescription, ordering, administration, or adaptation of ophthalmic lenses, contact
 lenses, ophthalmic devices, pharmaceutical agents, laboratory tests, or ocular exercises to
 diagnose and treat diseases, defects, or other abnormal conditions of the human eye and its
 adnexa;
         (d) display of any advertisement, circular, sign, or device offering to:
         (i) examine the eyes;
         (ii) fit glasses or contact lenses; or
         (iii) adjust frames;
         (e) removal of a foreign body from the eye or its adnexa, that is not deeper than the
 anterior 1/2 of the cornea; [and]
         (f) consultation regarding the eye and its adnexa with other appropriate health care
 providers, including referral to other appropriate health care providers[.]; and
         (g) performing a procedure that is described in Section 58-16a-602.
         (12) "Pharmaceutical agent" means any diagnostic or therapeutic drug or combination
 of drugs that has the property of assisting in the diagnosis, prevention, treatment, or mitigation
 of abnormal conditions or symptoms of the eye and its adnexa.
         (13) "Physician" has the same meaning as defined in Sections 58-67-102 and
 58-68-102.
         (14) "Prescription drug" has the same definition as in Section 58-17b-102.
         (15) "Unexpired" means a prescription that was issued:
         (a) for ophthalmic lenses which does not expire unless the optometrist or physician
 includes an expiration date on the prescription based on medical reasons that are documented
 in the patient's file; and
         (b) in accordance with Subsection (3) for a contact lens.
         Section 2. Section 58-16a-501 is amended to read:
                                                       -4-
        02-24-24 7:04 PM                                                     1st Sub. (Green) S.B. 210
           58-16a-501. Unlawful conduct.
           "Unlawful conduct" includes, in addition to the definition in Section 58-1-501:
           (1) buying, selling, or fraudulently obtaining, any optometry diploma, license,
 certificate, or registration;
           (2) selling or providing contact lenses or ophthalmic lenses in a manner inconsistent
 with Section 58-16a-801 or intentionally altering a prescription unless the person selling or
 providing the lenses is a licensed optometrist or ophthalmologist; [or]
           (3) representing oneself as or using the title of "optometrist," "optometric physician,"
 "doctor of optometry," or "O.D.," unless currently licensed under this chapter[.]; or
           (4) performing a procedure described in Section 58-16a-602 without obtaining the
 certification described in Section 58-16a-602.
           Section 3. Section 58-16a-502 is amended to read:
           58-16a-502. Unprofessional conduct.
           "Unprofessional conduct" includes, in addition to the definition in Section 58-1-501:
           (1) using or employing the services of an optometric assistant to assist a licensee in any
 manner not in accordance with:
           (a) the generally recognized practices and standards of ethics of the profession; or
           (b) applicable state law or division rule;
           (2) failure to refer a patient to an appropriate licensed practitioner when:
           (a) the patient's condition does not respond to treatment; or
           (b) the treatment is not within the scope of competence or licensure of the licensee;
           (3) providing confidential information regarding a patient to any third party who does
 not have a legal and professional ground for obtaining the information;
           (4) knowingly prescribing, selling, giving away, or administering any prescription drug
 unless:
           (a) for a legitimate medical purpose;
           (b) upon a proper diagnosis indicating the use of the drug in the amount prescribed or
 provided; and
           (c) in compliance with Section 58-17b-309;
           (5) giving or receiving directly or indirectly any fee, commission, rebate, or other
 compensation for professional services not actually and personally rendered, except as part of a
                                                        -5-
        1st Sub. (Green) S.B. 210                                                     02-24-24 7:04 PM
 legal relationship within a lawful professional partnership, corporation, or association;
        (6) failure to transfer pertinent and necessary information from a patient's medical
 records to another optometrist or physician when so requested by the patient or his
 representative, as designated in writing;
        (7) failure to provide a contact lens prescription to a person who sells contact lenses in
 accordance with Section 58-16a-306; [or]
        (8) falsely making an entry in, or altering, a medical record with the intent to conceal:
        (a) a wrongful or negligent act or omission of an individual licensed under this chapter
 or an individual under the direction or control of an individual licensed under this chapter; or
        (b) conduct described in Subsections (1) through (7) or Subsection 58-1-501(1)[.]; or
        (9) falsely reporting data required under Section 58-16a-602.
        Section 4. Section 58-16a-601 is amended to read:
        58-16a-601. Scope of practice.
        (1) An optometrist may:
        (a) provide optometric services not specifically prohibited under this chapter or
 division rules if the services are within the optometrist's training, skills, and scope of
 competence; and
        (b) prescribe or administer pharmaceutical agents for the eye and its adnexa, including
 oral agents, subject to the following conditions:
        (i) an optometrist may prescribe oral antibiotics for only eyelid related ocular
 conditions or diseases, and other ocular conditions or diseases specified by division rule; and
        (ii) an optometrist may administer or prescribe a hydrocodone combination drug, or a
 Schedule III controlled substance, as defined in Section 58-37-4, only if:
        (A) the substance is administered or prescribed for pain of the eye or adnexa;
        (B) the substance is administered orally or topically or is prescribed for oral or topical
 use;
        (C) the amount of the substance administered or prescribed does not exceed a 72-hour
 quantity; and
        (D) if the substance is prescribed, the prescription does not include refills.
        (2) An optometrist may not:
        (a) except as provided in Section 58-16a-602, perform surgery, including laser surgery;
                                                       -6-
        02-24-24 7:04 PM                                                   1st Sub. (Green) S.B. 210
 or
        (b) prescribe or administer a Schedule II controlled substance, as defined in Section
 58-37-4, except for a hydrocodone combination drug, if so scheduled and prescribed or
 administered in accordance with Subsection (1)(b).
        (3) For purposes of Sections 31A-22-618 and 31A-45-303, an optometrist is a health
 care provider.
        Section 5. Section 58-16a-602 is enacted to read:
        58-16a-602. Certification for certain laser procedures.
        (1) As used in this section:
        (a) "Certified optometrist" means an optometrist who has obtained:
        (i) a full certification; or
        (ii) a limited certification.
        (b) "Full certification" means a certification indicating that an optometrist may perform
 a YAG laser capsulotomy without any form of supervision.
        (c) "Limited certification" means a certification indicating that an optometrist may
 perform a YAG laser capsulotomy if under the direct supervision of an ophthalmologist.
        (d) "Physician board" means the board created in Section 58-67-201.
        (e) "Qualifying coursework" means coursework that:
        (i) meets minimum standards for performing a YAG laser capsulotomy as determined
 by the division through rule in consultation with the board and the physician board; and
        (ii) includes a course on informed consent; and
        (iii) may be completed:
        (A) as part of a an accredited optometry doctoral program; or
        (B) as a course or multiple courses after graduation.
        (f) "Supervising professional" means:
        (i) an ophthalmologist; or
        (ii) a certified optometrist who is a professor or adjunct professor at an accredited
 optometry school located in the state if the optometrist being supervised graduated from an
 accredited school of optometry in the state after July 1, 2026.
        (g) "YAG laser capsulotomy" means using a neodymium-doped yttrium aluminum
 garnet laser to treat opacification of the lens capsule after cataract surgery or lens replacement
                                                      -7-
        1st Sub. (Green) S.B. 210                                                    02-24-24 7:04 PM
 surgery.
        (2) To obtain a limited certification to perform YAG laser capsulotomy, an optometrist
 shall provide proof of:
        (a) completing qualifying coursework; and
        (b) establishing a relationship with a supervising professional.
        (3) A certified optometrist with a limited certification may obtain a full certification
 after providing:
        (a) proof of:
        (i) performing at least ten YAG laser capsulotomy procedures on live patients under
 the direct supervision of a supervising professional; and
        (ii) being engaged in the practice of optometry for at least 3,000 hours in the preceding
 two years; and
        (b) documentation signed by the supervising professional that:
        (i) confirms the completion of the procedures described in Subsection (3)(a)(i); and
        (ii) based on the supervising professional's observation, nothing indicates the certified
 optometrist should not obtain a full certification.
        (4) A certified optometrist may not perform a YAG laser capsulotomy on a patient that
 had cataract surgery within the previous year unless the surgeon who performed the cataract
 surgery approves the procedure.
        (5) A certified optometrist shall:
        (a) if the certified optometrist has a limited certification, maintain a relationship with a
 supervising professional until the certified optometrist obtains a full certification;
        (b) submit to the division all patient outcome data requested by the division under this
 section;
        (c) meet continuing education requirements;
        (d) disclose procedure risk to any patient undergoing a procedure;
        (e) provide to the patient:
        (i) a form detailing how to file a complaint with the division regarding procedures
 provided by the certified optometrist;
        (ii) a statement informing the patient that:
        (A) the certified optometrist is certified to perform the procedure;