SENATE BILL REPORT

                   SB 5874

              As Reported By Senate Committee On:

           Health & Long‑Term Care, February 2, 2000

Title:  An act relating to authorizing optometrists to use and prescribe approved drugs for diagnostic or therapeutic purposes without limitation upon the methods of delivery in the practice of optometry.

Brief Description:  Concerning optometrists' use of approved drugs.

Sponsors:  Senators Deccio, Franklin, Hale, Prentice, Costa, Loveland, B. Sheldon, Fairley, Kline, Spanel, Hochstatter, Long, Shin and McAuliffe.

Brief History:

Committee Activity:  Health & Long‑Term Care:  3/3/99; 1/13/00, 2/2/00 [DPS].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report:  That Substitute Senate Bill No. 5874 be substituted therefor, and the substitute bill do pass.

  Signed by Senators Thibaudeau, Chair; Costa, Deccio, Franklin, Johnson and Winsley.

Staff:  Joan K. Mell (786-7447)

Background:  Optometry is the examination and ascertaining of any defects of the human vision system and the analysis of the process of vision.  Under present law, optometrists can treat with topically applied drugs, but cannot inject drugs nor prescribe medication for oral use.

In November of 1996, the Department of Health issued an Optometrist Prescriptive Authority Sunrise Review.  The report concluded optometrists should be allowed to dispense and prescribe non-topical drugs and controlled substances specifically limited to those drugs necessary to treat diseases or conditions of the eye that are within the scope of practice of optometry for a period of seven days for any single condition.

Summary of Substitute Bill:  The practice of optometry is redefined to include the treatment of the human eye and the human vision system.

Optometrists could prescribe drugs administered orally with a special certification obtained after an additional minimum of 20 hours of didactic and clinical instruction.  A controlled substance may not be prescribed more than seven days for a single condition.  Schedule II controlled substances may only be prescribed for pain pursuant to a protocol.  Optometrists must not administer by injection.  The Optometry Board and Medical Commission develop protocol rules.  The Board of Pharmacy works with the Board of Optometry to develop a formulary of drugs.

The optometry board is given rule-making authority.

Optometrists are added to the list of practitioners in the Controlled Substances Act, and are given prescriptive authority under the legend drugs provisions.

Substitute Bill Compared to Original Bill:  Hospital discrimination provisions are removed.  Technical language changes are made; optometrists would not refer to themselves as optometric physicians.  Restrictions are added to optometrists= prescribing authority for schedule II controlled substances.

Appropriation:  None.

Fiscal Note:  Available.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  Patients are seen for conditions that are painful and could be treated with pain medication, but treatment can be delayed because an optometrist cannot prescribe oral pain medications.  Optometrists= education and experience make them competent to handle additional prescriptive authority, as is indicated in the sunrise review.

Testimony Against:  Optometrists do not have the training necessary to appropriately and safely prescribe controlled substances.

Testified:  PRO:  Jerry Falley, WAOP; Dr. Kathy Yang-Williams TLC Eye Northwest; Dr. Linda Casser, VP, Academic Affairs Pacific University; John Guadnola, WAOP legal counsel; CON:  Enid Layes, Craig Wells, MD, Lenny Alenick, MD, Mark Corley, MD, WA Academy of Eye Physicians and Surgeons; Carl Nelson, WSMA; Jeff Larsen, WOMA; Andy Davidson, WSHA.