WSR 10-21-067

PERMANENT RULES

DEPARTMENT OF HEALTH


(Board of Optometry)

[ Filed October 15, 2010, 4:14 p.m. , effective November 15, 2010 ]


Effective Date of Rule: Thirty-one days after filing.

Purpose: Optometrists whose license is not certified at the highest level must complete sixteen hours of didactic training, eight hours of supervised clinical experience and four hours of training in epinephrine by injection by January 1, 2011. The purpose of this rule is to allow consideration of current licensure at substantially equivalent standards in other states as meeting the certification requirements for optometrists currently licensed in Washington.

Citation of Existing Rules Affected by this Order: Amending WAC 246-851-570 and 246-851-600.

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

Adopted under notice filed as WSR 10-16-115 on August 2, 2010.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 2, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 2, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 0, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 2, Repealed 0.

Date Adopted: September 17, 2010.

Michael VanBrocklin, O.D.

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