WSR 10-16-115

PROPOSED RULES

DEPARTMENT OF HEALTH


(Board of Optometry)

[ Filed August 2, 2010, 4:57 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 10-12-055.

Title of Rule and Other Identifying Information: WAC 246-851-570 Certification required for use or prescription of drugs administered orally for diagnostic or therapeutic purposes and 246-851-600 Certification required for administration of epinephrine by injection for treatment of anaphylactic shock.

Hearing Location(s): Department of Health, 20435 72nd South, Second Floor, Conference Room 2, Kent, WA 98032, on September 17, 2010, at 11:00 a.m.

Date of Intended Adoption: September 17, 2010.

Submit Written Comments to: Judy Haenke, P.O. Box 47852, Olympia, WA 98504-7852, web site http://www3.doh.wa.gov/policyreview/, fax (360) 236-2901, by September 16, 2010.

Assistance for Persons with Disabilities: Contact Judy Hanke [Haenke] by September 9, 2010, TTY (800) 833-6388 or 711.

Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Effective January 1, 2011, all optometrists licensed in Washington state must be certified to use oral drugs and epinephrine by injection for anaphylactic shock. The proposed rules will recognize that this requirement has been met if a licensed optometrist, with an active license in another state with substantially equivalent standards, has completed similar certification.

Reasons Supporting Proposal: RCW 18.53.010 requires that all optometrists in Washington state provide evidence of certification to use oral drugs and epinephrine by injection for anaphylactic shock by January 1, 2011. The purpose of this rule is to allow consideration of practice at substantially equivalent standards in other states as meeting the certification requirements for optometrists currently licensed in Washington.

Statutory Authority for Adoption: RCW 18.54.070(2) and 18.53.010.

Statute Being Implemented: RCW 18.53.010.

Rule is not necessitated by federal law, federal or state court decision.

Name of Proponent: Department of health, board of optometry, governmental.

Name of Agency Personnel Responsible for Drafting, Implementation and Enforcement: Judy Haenke, Program Manager, 310 Israel Road S.E., Tumwater, WA 98501, (360) 236-4947.

No small business economic impact statement has been prepared under chapter 19.85 RCW. Under RCW 19.85.025 and 34.05.310 (4)(g)(ii), a small business economic impact statement is not required for proposed rules that adopt, amend, or repeal a filing or related process requirement for applying to an agency for a license or permit.

A cost-benefit analysis is not required under RCW 34.05.328. The agency did not complete a cost-benefit analysis under RCW 34.05.328. RCW 34.05.328 (5)(a) exempts rules that, by definition, are not significant legislative rules. By definition this rule qualifies under RCW 34.05.328 (5)(c)(ii) as an "interpretive rule." A preliminary cost-benefit analysis may be obtained by contacting Judy Haenke, Program Manager, 310 Israel Road S.E., Tumwater, WA 98501, phone (360) 236-4947, fax (360) 236-2901, e-mail judy.haenke@doh.wa.gov.

August 2, 2010

Michael Van Brocklin, OD

Chair, Board of Optometry

OTS-3290.3


AMENDATORY SECTION(Amending WSR 04-05-004, filed 2/5/04, effective 3/7/04)

WAC 246-851-570   Certification required for use or prescription of drugs administered orally for diagnostic or therapeutic purposes.   (1) To qualify for certification to use or prescribe drugs administered orally for diagnostic or therapeutic purposes, a licensed optometrist((s)) must provide documentation that he or she:

(a) ((Are)) Is certified ((under RCW 18.53.010 (2)(b))) to use or prescribe topical drugs for diagnostic and therapeutic purposes((.

(b) Have)) under WAC 246-851-400 and has successfully completed a minimum of sixteen hours of didactic and eight hours of supervised clinical instruction from an institution of higher learning, accredited by those agencies recognized by the United States Office of Education or the Council on Postsecondary Accreditation; or

(b) Holds a current active optometry license in another state that has licensing standards substantially equivalent to those in Washington state. The licensee's level of licensure must also be substantially equivalent to the licensing standards in Washington state.

(2) The didactic instruction must include a minimum of sixteen hours in the following subject area:

(a) Basic principles of systemic drug therapy;

(b) Side effects, adverse reactions and drug interactions in systemic therapy;

(c) Review of oral pharmaceuticals:

(i) Prescription writing;

(ii) Legal regulations in oral prescription writing;

(iii) Systemic antibacterials in primary eye care;

(iv) Systemic antivirals in eye care;

(v) Systemic antifungal in eye care;

(vi) Systemic antihistamines and decongestants and their uses in eye care;

(vii) Oral dry eye agents;

(viii) Anti-emetics and their use in eye care;

(ix) Systemic diuretics and their management of elevated IOP;

(x) Systemic epinephrine;

(d) Review of systemic medication in ocular pain management:

(i) Legal regulations with scheduled medication;

(ii) Systemic nonsteroidal anti-inflammatory drugs (NSAIDS);

(iii) Systemic noncontrolled analgesics;

(iv) Systemic controlled substances;

(e) Review of oral medications used for sedation and anti-anxiety properties in eye care:

(i) Controlled anti-anxiety/sedative substances;

(ii) Legal ramifications of prescribing anti-anxiety drugs;

(f) Review of systemic medications used during pregnancy and in pediatric eye care:

(i) Legal ramifications in prescribing to this population;

(ii) Dosage equivalent with pregnancy and pediatrics;

(iii) Medications to avoid with pregnancy and pediatrics;

(g) Applied systemic pharmacology:

(i) Eyelid and adnexal tissue;

(ii) Lacrimal system and peri-orbital sinuses;

(iii) Conjunctival and corneal disorders;

(iv) Iris and anterior chamber disorders;

(v) Posterior segment disorders;

(vi) Optic nerve disease;

(vii) Peripheral vascular disease and its relationship with ocular disease;

(viii) Atherosclerotic disease;

(ix) Other/course review.

(3) The supervised clinical instruction must include at least eight hours in the following subject areas:

(a) Vital signs;

(b) Auscultation;

(c) Ear, nose and throat;

(d) Screening neurological exam.

(4) Written examination to cover required curriculum.

[Statutory Authority: 2003 c 142 and RCW 18.54.072(2). 04-05-004, 246-851-570, filed 2/5/04, effective 3/7/04.]


AMENDATORY SECTION(Amending WSR 04-05-004, filed 2/5/04, effective 3/7/04)

WAC 246-851-600   Certification required for administration of epinephrine by injection for treatment of anaphylactic shock.   (1) To qualify for certification to administer epinephrine by injection for anaphylactic shock, licensed optometrists must provide documentation that he or she:

(a) ((Are)) Is certified ((under RCW 18.53.010 (2)(b))) to use or prescribe topical drugs for diagnostic and therapeutic purposes((.

(b) Have)) under WAC 246-851-400 and has successfully completed a minimum of four hours of didactic and supervised clinical instruction from an institution of higher learning, accredited by those agencies recognized by the United States Office of Education or the Council on Postsecondary Accreditation to qualify for certification by the optometry board to administer epinephrine by injection; or

(b) Holds a current active license in another state that has licensing standards substantially equivalent to those in Washington state. The licensee's level of licensure must also be substantially equivalent to the licensing standards in Washington state.

(2) The didactic instruction must include the following subject area:

(a) Review of urgencies, emergencies and emergency-use agents;

(b) Ocular urgencies:

(i) Thermal burns-direct and photosensitivity-based ultraviolet burn;

(ii) Electrical injury;

(iii) Cryo-injury and frostbite;

(iv) Insect stings and bites;

(v) Punctures, perforations, and lacerations;

(c) General urgencies and emergencies:

(i) Anaphylaxis;

(ii) Hypoglycemic crisis;

(iii) Narcotic overdose.

(3) The supervised clinical instruction must include the following subject areas:

(a) Instrumentation;

(b) Informed consent;

(c) Preparation (patient and equipment);

(d) All routes of injections.

(4) With the exception of the administration of epinephrine by injection for treatment of anaphylactic shock, no injections or infusions may be administered by an optometrist.

[Statutory Authority: 2003 c 142 and RCW 18.54.072(2). 04-05-004, 246-851-600, filed 2/5/04, effective 3/7/04.]

Washington State Code Reviser's Office