New Jersey-2022-A5445-Introduced

An Act concerning the practice of optometry and amending various parts of the statutory law.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. R.S.45:12-1 is amended to read as follows:

45:12-1 Optometry is hereby declared to be a profession, and the practice of optometry is defined to be the employment of objective or subjective means, or both, for the examination of the human eye and adnexae for the purposes of ascertaining any departure from the normal, measuring its powers of vision and adapting lenses [or], prisms, or vision training for the aid thereof[, or the use and prescription of pharmaceutical agents, excluding injections, except for injections to counter anaphylactic reaction, and excluding controlled dangerous substances as provided in sections 5 and 6 of P.L.1970, c.226 (C.24:21-5 and C.24:21-6), except as otherwise authorized by section 9 of P.L.1991, c.385 (C.45:12-9.11),] and the administration and performance of any diagnostic or therapeutic modality reasonable for the purposes of diagnosing and treating deficiencies, deformities, diseases, or abnormalities of the human eye and adnexae, including [the removal of superficial foreign bodies from the eye and adnexae. The practice of optometry shall include the administration of immunizations against coronaviruses and influenza by any route or modality, provided that administration of the immunization is consistent with recommendations issued by the Advisory Committee for Immunization Practices in the federal Centers for Disease Control and Prevention and complies with the requirements of section 2 of P.L.2021, c.101 (C.45:12-1.1)], but not limited to:

a. the employment of any means for the measurement of the powers of vision or the adaptation of lenses or prisms for the aid thereof;

b. the use of testing appliances for the purposes of measurement of the powers of vision or the diagnosis or any ocuolar deficiency, disease, or deformity, or visual or muscular anomaly of the human eye;

c. prescribing of lenses, prisms, eyeglass lenses, prosthetic eyes, vision therapy, orthotic therapy or ocular exercises for the correction, relief or rehabilitation of any (1) ocular deficiency or deformity, (2) visual or muscular anomaly or (3) disease of the human eye or the process of vision;

d. the use and prescription of pharmaceutical agents by any route of administration including controlled dangerous substances;

e. the prescription or administration, or both, of epinephrine or equivalent medication to counteract anaphylaxis or anaphylactic reactions;

f. the removal of superficial foreign bodies from the eye and adnexae;

g. the performance or ordering of procedures and laboratory tests appropriate for the diagnosis of conditions or diseases of the eye, adnexae, and visual system;

h. the administration of immunizations against coronaviruses, influenza, and varicella-zoster virus by any route or modality, provided that administration of the immunization is consistent with recommendations issued by the Advisory Committee on Immunization Practices in the United States Centers for Disease Control and Prevention. An optometrist shall not administer an immunization against a coronavirus, influenza, or varicella-zoster virus pursuant to this section to any patient who is younger than 18 years of age. An immunization against a coronaviruses, influenza, and varicella-zoster virus administered to a patient by an optometrist under this section shall be reported by the optometrist to the New Jersey Immunization Information System established pursuant to section 4 of P.L.2004, c.138 (C.26:4-134) for inclusion in the patient's registry;

i. simple ophthalmologic procedures including non-invasive application of laser and ultrasound, reasonable and limited to the diagnosis and treatment of conditions or disease of the eye, adnexae, and visual systems, including but not limited to trabeculoplasty, capsulotomy, and iridotomy performed with topical anesthesia, as determined solely by the New Jersey State Board of Optometrists;

j. minor procedures including simple ophthalmologic procedures including, but not limited to, treatment of chalazions, excision of skin tags and other lesions without clinical characteristics of malignancy, performed with a local anesthesia as determined by the New Jersey State Board of Optometrists, except that these applications and minor procedures shall not include:

(1) invasive, intra-ocular surgery, defined as those surgical procedures which require a full thickness incision of the globe of the eye;

(2) orbital surgery including strabismus surgery or any surgical procedure which requires an incision of the orbital septum, surgical procedures, or repair of wounds which require suturing in layers; and

(3) any surgical procedure performed under general anesthesia or the administration of general anesthesia; and

k. provision of pre- and post-operative care of procedures included in paragraphs (1), (2), and (3) of subsection j. of this section.

An optometrist [utilizing pharmaceutical agents], for the purposes of treatment of ocular conditions and diseases, shall be held to a standard of patient care [in the use of such agents] commensurate to that of a [physician utilizing pharmaceutical agents for treatment purposes] licensee of the State Board of Medical Examiners performing the same procedures.

A person shall be deemed to be practicing optometry within the meaning of this chapter who in any way [advertises himself as an optometrist, or who shall employ any means for the measurement of the powers of vision or the adaptation of lenses or prisms for the aid thereof, practice, offer or attempt to practice] practices optometry as herein defined, either on his own behalf or as an employee or student of another, whether under the personal supervision of his employer or perceptor or not, or to use testing appliances for the purposes of measurement of the powers of vision or diagnose any ocular deficiency or deformity, visual or muscular anomaly of the human eye and adnexae or prescribe lenses, prisms or ocular exercise for the correction or the relief thereof, or who uses or prescribes pharmaceutical agents for the purposes of diagnosing and treating deficiencies, deformities, diseases or abnormalities of the human eye and adnexae or who holds himself out as qualified to practice optometry.

(cf: P.L.2021, c.101, s.1)

2. R.S.45:12-8 is amended to read as follows:

45:12-8 Every person practicing optometry shall display his registration certificate or certificates, together with his registration renewal certificate or certificates, in a conspicuous place in the office or offices wherein he practices optometry, but not in such manner that they may be seen from the outside of such office or offices, and, whenever required, exhibit the registration and renewal certificates to the board or its authorized representatives. Every office where an optometrist is practicing shall have displayed on a sign so as to be read on the outside of the office the name of each optometrist practicing therein. When practicing the profession of optometry outside of or away from the office he shall deliver to each patient a bill for professional services rendered, which shall contain his full name, [home post-office address and] the address of his principal office in this State, the number of his certificates, and his signature.

Every person practicing optometry in New Jersey shall notify the board in writing of any change of address or location of his office or offices at least 5 days prior to occupying said new office, returning therewith the appropriate registration renewal certificate or certificates and the board shall issue a new registration renewal certificate or certificates for the new office location or locations.

(cf: P.L.1954, c.227, s.3)

3. Section 7 of P.L.1991, c.385 (C.45:12-9.9) is amended to read as follows:

7. The New Jersey State Board of Optometrists shall [establish the credentialing requirements which shall be fulfilled before a person may be certified] authorize a licensee of the board to use or prescribe pharmaceutical agents or perform simple ophthalmologic procedures and other minor procedures for treatment purposes in the practice of optometry upon submission to the board of evidence of competence to perform the minor procedures requested. Evidence of competence shall include completion of a course of study administered by a school or college of optometry accredited by the Accreditation Council on Optometric Education of the American Optometric Association and by attestation from an optometrist authorized to perform such procedures or an ophthalmologist licensed in New Jersey and certified by the American Board of Ophthalmology who has proctored the licensee under direct supervision to perform such procedures. These educational standards shall be no less than that required of currently-enrolled students as part of the requirements for graduation. Licensees shall be immediately authorized at their current level of practice. A licensee currently certified to use and prescribe pharmaceutical agents for treatment purposes pursuant to P.L.1991, c.385 (C.45:12-9.8 et seq.) shall be immediately credentialed and certified to use and prescribe pharmaceutical agents authorized by that act for treatment purposes in the practice of optometry.

Prior to authorization by the New Jersey State Board of Optometrists to perform simple ophthalmologic procedures and other minor procedures, as determined by the board, an optometrist who holds an active license to practice optometry in New Jersey shall be permitted to perform simple ophthalmologic procedures and other minor procedures, as determined by the board, only when enrolled in an approved program of training sponsored by a school or college of optometry accredited by the Accreditation Council on Optometric Education of the American Optometric Association, and only when under the direct supervision of a properly authorized optometrist authorized to perform such procedures or an ophthalmologist licensed in New Jersey and certified by the American Board of Ophthalmology in order to fulfill the requirements of that training program. Training programs and each licensee registered to participate in a recognized training program shall be registered with the board prior to the commencement of the program or the participation.

In addition, the board shall establish continuing education requirements for the renewal of [certification] authorization for the use and prescription of pharmaceutical agents and the performance of simple ophthalmologic procedures and other minor procedures for treatment purposes in the practice of optometry. [No licensee shall be tested by the board for certification to use or prescribe pharmaceutical agents for treatment purposes in the practice of optometry before having first satisfactorily completed all educational requirements in ocular pharmacology at a school duly accredited by the United States Department of Education and the Council on Postsecondary Accreditation. These educational standards shall be no less than that required of currently enrolled students as part of their requirements for graduation from that school. This credentialing and certification process shall be required of all persons seeking to utilize pharmaceutical agents for treatment purposes in the practice of optometry regardless of licensure either prior or subsequent to the effective date of P.L.1991, c.385 (C.45:12-9.8 et seq.); except that licensees shall be immediately certified at their current level of practice and those licensees currently certified to use and prescribe pharmaceutical agents for treatment purposes pursuant to P.L.1991, c.385 (C.45:12-9.8 et seq.) shall be immediately credentialed and certified to use and prescribe those pharmaceutical agents authorized by that act for treatment purposes in the practice of optometry but not orally until certified, except for injections to counter anaphylactic reactions.]

The board shall maintain a list of all approved [credentialing] courses, which list shall be made available upon request to licensees or other interested persons. Upon receipt of verification of satisfactory completion of an approved [credentialing] course of study, the board shall [certify] authorize the optometrist applicant [as certified] in the use and prescription of those pharmaceutical agents and the performance of simple ophthalmologic procedures and other minor procedures.

(cf: P.L.2004, c.115, s.3)

4. Section 9 of P.L.1991, c.385 (C.45:12-9.11) is amended to read as follows:

9. a. Whenever in any law there is a requirement or duty with respect to the prescription, administration or dispensing of any drug which applies to any person authorized to prescribe that drug, the same shall apply to an optometrist when prescribing, administering or dispensing a pharmaceutical agent pursuant to R.S.45:12-1, except that an optometrist shall not dispense a prescription as provided for in R.S.45:12-1 in an amount exceeding a 72-hour supply of that prescription unless the prescription is dispensed at no charge to the patient. [Subject to the provisions of P.L.1991, c.385 (C.45:12-9.8 et seq.), an optometrist authorized to prescribe, administer, or dispense a pharmaceutical agent shall be permitted to prescribe, administer, and dispense for the purpose of diagnosing and treating deficiencies, deformities, diseases, or abnormalities of the human eye and adnexae pharmaceutical agents classified as Schedule III, IV, and V controlled dangerous substances and, regardless of schedule, pharmaceutical agents containing hydrocodone.]

b. Notwithstanding the provisions of subsection a. of this section, an optometrist may dispense a pharmaceutical agent, as provided for in R.S.45:12-1, that is delivered to the eye through a contact lens or other medical device or through any other route of administration approved by the board and may dispense such pharmaceutical agent at a charge to the patient.

(cf: P.L.2015, c.65, s.1)

5. Section 10 of P.L.2004, c.115 (C.45:12-9.13) is amended to read as follows:

10. No licensee shall be certified by the New Jersey State Board of Optometrists to use or prescribe pharmaceutical agents in the practice of optometry before having completed credentialing requirements in ocular pharmacology approved and administered by the New Jersey State Board of Optometrists. [Until such time as a majority of the optometrist members of the New Jersey State Board of Optometrists are certified to use and prescribe pharmaceutical agents for treatment purposes in the practice of optometry, an interim four-member panel of experts in ocular pharmacology shall be established to prepare or endorse credentialing requirements for board approval. The interim advisory panel of experts in ocular pharmacology shall be comprised of a physician selected by the State Board of Medical Examiners, a member selected by the Board of Pharmacy, a representative of a school of optometry duly accredited by the United States Department of Education and the Council on Postsecondary Accreditation, to be selected by the New Jersey State Board of Optometrists, and the Commissioner of the Department of Health and Senior Services or his designee. The interim panel shall be selected by the respective boards within 90 days of the effective date of this amendatory and supplementary act. Panel members shall be directly responsible to the Director of the Division of Consumer Affairs, who may order the replacement of any panel member for failure to promptly and equitably fulfill their duties. The panel shall have 120 days following appointment of a majority of the panel to submit to the New Jersey State Board of Optometrists credentialing requirements in ocular pharmacology. Should the panel fail within the 120 day period to submit credentialing requirements to the New Jersey State Board of Optometrists, the Director of the Division of Consumer Affairs shall designate, within 90 days thereafter, the credentialing requirements for the interim period. Should the Director of the Division of Consumer Affairs fail to designate credentialing requirements within the 90-day period, the credentialing requirements shall be designated by the New Jersey State Board of Optometrists.]

(cf: P.L.2004, c.115, s.10)

6. Section 7 of P.L.1948, c.350 (C.45:12-18.1) is amended to read as follows

7. The record of an optometrist of the examination of a patient, including patient's name, address, age, occupation, and all findings and pertinent facts concerning the patient discovered and disclosed during the course of such examination, as well as the record of professional services rendered and the fees charged therefor shall, because of the confidential nature in the relationship, be the exclusive property of the [optometrist who] optometric practice that rendered the professional services to the patient. Any unauthorized use by any other person, firm or corporation of the information contained therein shall constitute an infringement of the property rights of the patient and the [optometrist] optometric practice, and shall subject the offender to a civil suit for damages by the person aggrieved.

(cf: P.L.1948, c. 350, s.7)

7. This act shall take effect immediately.

STATEMENT

This bill updates the statute governing optometrists licensed in New Jersey by matching the scope of practice, services and treatments optometrists can offer patients with the optometrists' doctoral training, education, and clinical experience. Additionally, the bill clarifies requirements that an optometrist must complete prior to receiving authorization to perform certain services.