Bill Summary – FastDemocracy

LEGISLATIVE GENERAL COUNSEL                                          H.B. 224
Approved for Filing: D.M. Cheung 6                           1st Sub. (Buff)
          6 02-07-22 3:22 PM 6
                  Representative James A. Dunnigan proposes the following substitute bill:
                      OPTOMETRIST PRACTICE AMENDMENTS
                                      2022 GENERAL SESSION
                                           STATE OF UTAH
                              Chief Sponsor: James A. Dunnigan
                               Senate Sponsor: Curtis S. Bramble
 6
 LONG TITLE
 General Description:
        This bill amends the Utah Optometry Practice Act.
 Highlighted Provisions:
        This bill:
        < amends provisions relating to the supervision of an optometric assistant;
        < amends provisions relating to the scope of practice of an optometrist; and
        < makes technical changes.
 Money Appropriated in this Bill:
        None
 Other Special Clauses:
        None
 Utah Code Sections Affected:
 AMENDS:                                                                                 1st Sub. H.B. 224
        58-16a-102, as last amended by Laws of Utah 2020, Chapter 339
        58-16a-302, as last amended by Laws of Utah 2020, Chapter 339
        58-16a-601, as last amended by Laws of Utah 2017, Chapter 292
24
 Be it enacted by the Legislature of the state of Utah:
     *HB0224S01*
       1st Sub. (Buff) H.B. 224                                                     02-07-22 3:22 PM
        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.
        (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 around and
                                                    -2-
       02-07-22 3:22 PM                                                    1st Sub. (Buff) H.B. 224
 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 who is not licensed under
 this chapter:
        (a) working under the [direct and immediate] indirect 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
 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] prescribing, ordering,
 administering, or adapting ophthalmic lenses, contact lenses, ophthalmic devices,
                                                     -3-
        1st Sub. (Buff) H.B. 224                                                   02-07-22 3:22 PM
 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.
         (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-302 is amended to read:
         58-16a-302. Qualifications for licensure.
         (1) An applicant for licensure as an optometrist shall:
         (a) submit an application in a form prescribed by the division;
         (b) pay a fee as determined by the division under Section 63J-1-504;
         (c) (i) be a doctoral graduate of a recognized school of optometry accredited by the
 American Optometric Association's Accreditation Council on Optometric Education; or
         (ii) be a graduate of a school of optometry located outside the United States that meets
 the criteria that would qualify the school for accreditation under Subsection (1)(c)(i), as
 demonstrated by the applicant for licensure;
                                                       -4-
        02-07-22 3:22 PM                                                      1st Sub. (Buff) H.B. 224
         (d) if the applicant graduated from a recognized school of optometry prior to July 1,
 1996, have successfully completed a course of study [satisfactory to] approved by the division,
 in consultation with the board, in general and ocular pharmacology and emergency medical
 care;
         (e) have passed examinations approved by the division in consultation with the board
 that include:
         (i) a standardized national optometry examination;
         (ii) a standardized clinical examination; and
         (iii) a standardized national therapeutics examination; and
         (f) meet with the board and representatives of the division, if requested by either party,
 for the purpose of evaluating the applicant's qualifications for licensure.
         (2) Notwithstanding Subsection (1) and Section 58-1-302, the division shall issue a
 license under this chapter by endorsement to an individual who:
         (a) submits an application for licensure by endorsement on a form approved by the
 division;
         (b) pays a fee established by the division in accordance with Section 63J-1-504;
         (c) verifies that the individual is licensed as an optometrist in good standing in each
 state of the United States, or province of Canada, in which the individual is currently licensed
 as an optometrist; and
         (d) has been actively engaged in the legal practice of optometry for at least 3,200 hours
 during the immediately preceding two years in a manner consistent with the legal practice of
 optometry in this state.
         Section 3. 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) subject to Subsection (1)(c), 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
                                                       -5-
        1st Sub. (Buff) H.B. 224                                                   02-07-22 3:22 PM
 conditions or diseases, and other ocular conditions or diseases specified by division rule; and]
        [(ii) an optometrist may] (c) administer or prescribe a hydrocodone combination drug,
 or a Schedule III controlled substance[,] as defined in Section 58-37-4, only if:
        [(A)] (i) the substance is administered or prescribed for pain of the eye or adnexa;
        [(B)] (ii) the substance is administered orally or topically or is prescribed for oral or
 topical use;
        [(C)] (iii) the amount of the substance administered or prescribed does not exceed a
 72-hour quantity; and
        [(D)] (iv) if the substance is prescribed, the prescription does not include refills[.]; and
        (d) subject to Subsections (2) and (3), perform the following laser surgical procedures
 if the procedure is within the optometrist's training, skills, and scope of competence:
        (i) a laser capsulotomy;
        (ii) a laser trabeculoplasty;
        (iii) a laser peripheral iridotomy; and
        (iv) a laser surgical procedure that is:
        (A) similar to the procedures described in Subsection (1)(d)(i) through (iii);
        (B) is taught as part of a doctoral program in optometry at a recognized school of
 optometry accredited by the American Optometric Association's Accreditation Council on
 Optometric Education; and
        (C) is approved by the division under Subsection (5).
        (2) An optometrist may not:
        (a) perform [surgery, including] a laser surgery[; or]under Subsection (1)(d) that the
 optometrist is not qualified to perform;
        (b) perform:
        (i) retina surgery, including scleral buckle surgery;
        (ii) laser refractive surgery of the ocular anterior segment, including laser-assisted in
 situ keratomileusis (LASIK) and photorefractive keratectomy (PRK);
        (iii) penetrating keratoplasty or lamellar keratoplasty;
        (iv) surgical extraction of the crystalline lens;
        (v) surgical implantation of intraocular lens implants;
        (vi) incisional or excisional surgery of the extraocular muscles;
                                                        -6-
       02-07-22 3:22 PM                                                      1st Sub. (Buff) H.B. 224
        (vii) incisional ocular surgery for the treatment of glaucoma; or
        (viii) non-laser surgery of the eyelid for:
        (A) eyelid malignancies;
        (B) incisional cosmetic or mechanical repair of blepharochalasis; or
        (C) ptosis; or
        [(b)] (c) except as provided in Subsection (1)(c), 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) An optometrist may perform a procedure described in Subsection (1)(d) only if:
        (a) the optometrist has successfully completed:
        (i) training in the use of the procedure as a condition of the optometrist's graduation
 from a doctoral program under Subsection 58-16a-302(1)(c);
        (ii) a course approved by the division that includes a live patient encounter; or
        (iii) (A) a course approved by the division that does not include a live patient
 encounter; and
        (B) proctored training for the procedure on a live patient that is completed no more
 than two years before the day on which the optometrist performs the procedure;
        (b) if an optometrist has not performed the procedure within the previous five year
 period, the optometrist has successfully completed a proctored training for the procedure no
 more than two years before the day on which the optometrist perform the procedure; and
        (c) the optometrist is available to provide emergency care outside of normal business
 hours to a patient upon whom the optometrist performs the procedure.
        (4) Proctored training under Subsection (3) may be proctored by an individual who:
        (a) is trained and experienced in the procedure being proctored; and
        (b) (i) (A) is licensed in good standing as a physician in the state or a state or territory
 of the United States outside of Utah; and
        (B) specializes in opthalmology; or
        (ii) (A) is licensed in good standing as an optometrist in the state or a state or territory
 of the United States outside of Utah; and
        (B) teaches and performs the procedure at a post-graduate medical training program or
 school of optometry that is accredited or recognized by the division.
                                                      -7-
        1st Sub. (Buff) H.B. 224                                                    02-07-22 3:22 PM
        (5) The division, in consultation with the board, shall make rules in accordance with
 Title 63G, Chapter 3, Utah Administrative Rulemaking Act, specifying:
        (a) if applicable, additional laser surgical procedures that an optometrist may perform
 under Subsection (1)(d)(iv); and
        (b) courses that satisfy the requirements in Subsections (3)(a)(ii) and (iii).
        [(3)] (6) For purposes of Sections 31A-22-618 and 31A-45-303, an optometrist is a
 health care provider.
218a    º (7) In a malpractice action against a health care provider under Title 78B, Chapter 3, Part
218b   4, Utah Health Care Malpractice Act, for a procedure described in Subsection (1)(d), an
218c optometrist shall be held to the same standard of care as a physician specializing in
218d opthalmology. »
                                                       -8-               House Floor Amendments 2-15-2022 lf/dc
Statutes affected: 
Introduced: 
Amended: 