[atlas:bill]

AN ACT Relating to authorizing dispensing opticians to perform eye refraction and modify existing prescriptions to reflect changes in vision; amending RCW 18.34.020, 18.34.060, 18.34.050, 18.34.080, 18.34.120, 18.34.136, and 18.34.010; adding new sections to chapter 18.34 RCW; recodifying RCW 18.34.010 and 18.34.060; repealing RCW 18.34.110; and providing an effective date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1. RCW 18.34.020 and 1995 c 178 s 1 are each amended to read as follows:

The term "secretary" wherever used in this chapter ((~~shall~~)) means the secretary of health of the state of Washington. The term "apprentice" wherever used in this chapter ((~~shall~~)) means a person who ((~~shall be~~)) is designated an apprentice in the records of the secretary at the request of a physician, registered optometrist, or licensee hereunder, who shall thereafter be the primary supervisor of the apprentice. The apprentice may thereafter receive from a physician, registered optometrist, or licensee hereunder training and direct supervision in the work of a dispensing optician. The term "refracting" whenever used in this chapter means the measurement of the powers or range of a person's vision by the use of a series of lenses and their rotation to determine the degree of correction needed to compensate for hyperopia, myopia, presbyopia, astigmatism, prism, or any combination of these. "Prescription modification" whenever used in this chapter, means the ability of a licensed refracting optician to alter a prescription within a cumulative plus or minus 2.00 diopter of change provided that there is no more than plus or minus 1.00 diopter of change at any one time during a six-month period. A licensed refracting optician must provide a patient with a copy of the changes to take with him or her to a provider of choice. The original prescriber will be notified in writing within fourteen days of any modifications made to the original prescription and will also be provided with a copy of the patient's questionnaire and the signed informed consent document.

Sec. 2. RCW 18.34.060 and 1957 c 43 s 6 are each amended to read as follows:

A dispensing optician is a person who prepares duplications of, or prepares and dispenses lenses, spectacles, eyeglasses and/or appurtenances thereto to the intended wearers thereof on written prescriptions from physicians or optometrists, and in accordance with ((~~such~~)) the prescriptions, measures, adapts, adjusts and fabricates ((~~such~~)) the lenses, spectacles, eyeglasses and/or appurtenances thereto to the human face for the aid or correction of visual or ocular anomalies of the human eye((~~: PROVIDED, HOWEVER, That~~)). However, contact lenses may be fitted only upon a written prescription of a physician or optometrist. A refracting optician is a licensed dispensing optician who has received an endorsement from the secretary to practice refractometry and to modify prescriptions.

Sec. 3. RCW 18.34.050 and 1984 c 287 s 32 are each amended to read as follows:

The dispensing optician examining committee shall meet at such times as deemed necessary by the secretary to prepare and administer the state's licensing examinations and to provide technical expertise, advice, and make recommendations to the secretary on the administration of the dispensing optician statute and disciplinary matters of licensees. The examining committee ((~~shall~~)) consists of ((~~three~~)) five persons. Four persons must be primarily engaged in the business of dispensing opticians and ((~~who currently~~)) hold a ((~~valid~~)) current license under this chapter. One of the licensed dispensing optician members shall be a licensed refracting optician. One member must be a member of the general public. Members of the committee shall be compensated in accordance with RCW 43.03.240 and shall be reimbursed for travel expenses in accordance with RCW 43.03.050 and 43.03.060.

NEW SECTION. Sec. 4. A new section is added to chapter 18.34 RCW to read as follows:

An applicant for endorsement as a refracting optician must first be licensed as a dispensing optician under this chapter and meet the following additional requirements:

(1) Completion of eighty hours of coursework from an accredited or approved institution or association including, but not limited to, the following topics: Theory of refraction, anatomy, pathology, and knowledge of equipment operation;

(2) Completion of two hundred refractive examinations. The two hundred refractive examinations are under the direct supervision of a licensed optometrist or a licensed ophthalmologist who shall certify the completion of the examinations and send notification directly to the department;

(3) Continuing education or competency requirements as determined by the secretary.

The secretary shall adopt by rule the examination requirements to endorse refracting opticians. An applicant for endorsement as a refracting optician may take the examination if he or she pays an examination fee, determined by the secretary, as provided in RCW 43.70.250.

A refracting optician who has successfully completed the requirements of this section will have the endorsement of "CRO" placed on his or her dispensing optician license by the secretary.

Sec. 5. RCW 18.34.080 and 1995 c 198 s 3 are each amended to read as follows:

(1) The examination to license a dispensing optician shall determine whether the applicant has a thorough knowledge of the principles governing the practice of a dispensing optician which is hereby declared necessary for the protection of the public health. The examining committee may ((~~approve an examination prepared or administered by a private testing agency or association of licensing authorities~~)) prepare and administer, or approve the preparation and administration of, examinations for applicants for licensure. The secretary shall license successful examinees and the license shall be conspicuously displayed in the place of business of the licensee.

(2) The written and practical examination to certify a refracting optician shall determine whether the applicant has a thorough knowledge of the principles governing the practice of refraction. After the initial exam, the examining committee may prepare and administer, or approve the preparation and administration of, examinations for applicants for licensure. The secretary shall issue an endorsement to successful examinees and the endorsement shall be conspicuously displayed in the place of business of the licensee.

Sec. 6. RCW 18.34.120 and 1996 c 191 s 18 are each amended to read as follows:

Each licensee ((~~hereunder~~)) or holder of an endorsement under this chapter shall pay a renewal registration fee determined by the secretary as provided in RCW 43.70.250 and 43.70.280. The secretary may adopt rules establishing mandatory continuing education requirements to be met by persons applying for license or endorsement renewal.

Sec. 7. RCW 18.34.136 and 1987 c 150 s 19 are each amended to read as follows:

The uniform disciplinary act, chapter 18.130 RCW, governs unlicensed practice, the issuance and denial of licenses, and the discipline of licensees under this chapter. No person may practice or represent himself or herself as a refracting optician without first having obtained an endorsement from the secretary.

Sec. 8. RCW 18.34.010 and 1957 c 43 s 1 are each amended to read as follows:

Nothing in this chapter shall:

(1) Be construed to limit or restrict a duly licensed physician or optometrist or employees working under the personal supervision of a duly licensed physician or optometrist from the practices enumerated in this chapter, and each such licensed physician and optometrist shall have all the rights and privileges which may accrue under this chapter to dispensing opticians licensed hereunder;

(2) Be construed to prohibit an unlicensed person from performing mechanical work upon inert matter in an optical office, laboratory, or shop;

(3) Be construed to prohibit an unlicensed person from engaging in the sale of spectacles, eyeglasses, magnifying glasses, goggles, sunglasses, telescopes, binoculars, or any such articles which are completely preassembled and sold only as merchandise;

(4) Be construed to authorize or permit a licensee ((~~hereunder~~)) under this chapter to hold himself or herself out as being able to, or to offer to, or to undertake to attempt, by any manner of means, to ((~~examine or~~)) exercise eyes, diagnose, treat, ((~~correct,~~)) relieve, operate, or prescribe for any human ailment, ((~~deficiency,~~)) deformity, disease, or injury.

If a licensed refracting optician is unable to select lenses that provide at a minimum 20/40 vision in either eye to the consumer, he or she shall refer the consumer to a licensed optometrist or ophthalmologist. If a licensed refracting optician is observing change of more than plus or minus 1.00 diopter of power in either eye, he or she shall refer the consumer to a licensed optometrist or ophthalmologist. A licensed refracting optician shall not modify an original prescription beyond plus or minus 2 diopters of change provided that there is no more than plus or minus 1.00 diopter of change at any one time during a six-month period. A licensed refracting optician may only modify a prescription for a consumer that has had an eye health exam within two years for contact lenses and within two years for glasses. A licensed refracting optician will not modify a prescription of a child ten years old or younger or an adult sixty-four years or older. A licensed refracting optician will notify in writing the original prescriber within fourteen days of any modifications made to the original prescription, and will also provide a copy of the patient's questionnaire and the signed informed consent document.

NEW SECTION. Sec. 9. RCW 18.34.110 (Existing practitioner--Fee) and 1991 c 3 s 78 & 1957 c 43 s 11 are each repealed.

NEW SECTION. Sec. 10. RCW 18.34.010, to be codified between RCW 18.34.141 and 18.34.900, and RCW 18.34.060, to be codified between RCW 18.34.020 and 18.34.030, are each recodified.

NEW SECTION. Sec. 11. Sections 2, 4 through 6, and 8 of this act take effect July 1, 2002.