April 6, 2007
ENGROSSED
HOUSE BILL No. 1349
_____
DIGEST OF HB 1349
(Updated April 4, 2007 12:35 pm - DI 104)
Citations Affected: IC 25-24; IC 35-48.
Synopsis: Legend drug prescriptions by optometrists. Specifies that
the practice of optometry does not include surgery or intravitreal
injection into the eye. Allows optometrists who are certified by the
optometric board to administer, dispense, and prescribe codeine with
certain compounds and hydrocodone with certain compounds under
specified circumstances. Requires an optometrist to examine the
patient before prescribing or dispensing certain drugs and to refer the
patient to a physician if the patient's pain does not improve after 48
hours. Adds an optometrist to the controlled substances advisory
committee and specifies that an affirmative vote of a majority of the
advisory committee members is necessary to take action. Repeals a law
concerning drug formulary requirements. Makes conforming changes.
Effective: July 1, 2007.
Welch, Frizzell, Reske
, Hoy
(SENATE SPONSORS _ MISHLER, SIMPSON, ROGERS)
January 16, 2007, read first time and referred to Committee on Public Health.
January 30, 2007, reported _ Do Pass.
February 6, 2007, read second time, ordered engrossed.
February 7, 2007, engrossed.
February 8, 2007, read third time, passed. Yeas 86, nays 0.
SENATE ACTION
February 19, 2007, read first time and referred to Committee on Health and Provider
Services.
April 5, 2007, amended, reported favorably _ Do Pass.
April 6, 2007
First Regular Session 115th General Assembly (2007)
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ENGROSSED
HOUSE BILL No. 1349
A BILL FOR AN ACT to amend the Indiana Code concerning
professions and occupations.
Be it enacted by the General Assembly of the State of Indiana:
SOURCE: IC 25-24-1-4; (07)EH1349.1.1. -->
SECTION 1. IC 25-24-1-4 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 4. (a) The practice of
optometry is hereby defined to be any one of the following acts, or any
combination of, or part of the following acts:
(a) (1) The:
(A) examination or optometric diagnosis of the human eye to
ascertain the presence of abnormal conditions or functions
which may be diagnosed, corrected, remedied or relieved; or
(B) the application or prescription of lenses, prisms, or
exercises; or any
(C) physical, mechanical, physiological, or psychological
therapy, or the employment of any means, for the purpose of
detecting any diseased or pathological condition of the eye, or
the effects of any diseased or pathological condition of the eye,
which that may have any significance in a complete
optometric diagnosis of the eye or it's the eye's associated
structures.
(b) (2) The:
(A) application, use, or adaption adaptation of physical,
anatomical, physiological, psychological, or any other
principles, through scientific professional methods and
devices, to the examination of the eyes and vision;
(B) measuring their of the eyes and vision function for the
purpose of determining the nature and degree of their the eye
or vision departure from the normal, if any; and
(C) adopting of optical, physiological and psychological
measures and/or the or furnishing or providing of any
prosthetic or therapeutic devices for the emendation thereof.
improvement of the eyes or vision.
(b) The term does not include:
(1) surgery (as described in IC 25-22.5-1-1.1), including laser
surgery; or
(2) intravitreal injection into the eye.
SOURCE: IC 25-24-3-6; (07)EH1349.1.2. -->
SECTION 2. IC 25-24-3-6, AS ADDED BY P.L.157-2006,
SECTION 65, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2007]: Sec. 6. (a) As used in this chapter, "legend drug" has
the meaning set forth in IC 16-18-2-199. The term includes only the
following narcotic drugs:
(1) codeine with compounds of aspirin or acetaminophen; and
(2) hydrocodone with compounds of aspirin or
acetaminophen.
(b) Subject to subsection (a), the term does not include:
(1) a schedule I controlled substances substance (as defined in
IC 35-48-1-9). IC 35-48-2-4);
(2) a schedule II controlled substance (as defined in
IC 35-48-2-6); or
(3) a schedule III controlled substance not described in
subsection (a).
SOURCE: IC 25-24-3-10; (07)EH1349.1.3. -->
SECTION 3. IC 25-24-3-10, AS ADDED BY P.L.157-2006,
SECTION 65, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2007]: Sec. 10. The board shall do the following:
(1) Adopt rules under IC 4-22-2 to do the following:
(A) Establish a formulary of legend drugs that may be
prescribed, dispensed, or administered by an optometrist.
(B) Set fees described in IC 25-1-8.
(C) Carry out this chapter.
(2) Except for a drug listed in subdivision (3), establish
education and training requirements in ocular pharmacology
required for certification to do the following:
(A) Administer therapeutic legend drugs.
(B) Dispense legend drugs.
(C) Prescribe legend drugs.
(3) Establish education and training requirements required
for certification to administer, dispense, or prescribe a
narcotic drug described in section 6(a) of this chapter.
(3) (4) Establish continuing education requirements for renewal
of the certificate issued under this chapter.
SOURCE: IC 25-24-3-12; (07)EH1349.1.4. -->
SECTION 4. IC 25-24-3-12, AS ADDED BY P.L.157-2006,
SECTION 65, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2007]: Sec. 12. (a) The board shall issue a an optometric
legend drug certificate to a licensed optometrist who:
(1) applies; and
(2) successfully fulfills all the requirements of section 10(2) of
this chapter.
(b) The board shall issue an optometric controlled substance
certificate to a licensed optometrist who:
(1) applies; and
(2) successfully fulfills the requirements of section 10(3) of this
chapter.
SOURCE: IC 25-24-3-16; (07)EH1349.1.5. -->
SECTION 5. IC 25-24-3-16, AS ADDED BY P.L.157-2006,
SECTION 65, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2007]: Sec. 16. (a) Optometrists may administer topical
diagnostic legend drugs limited to:
(1) miotics;
(2) mydriatics;
(3) anesthetics; and
(4) cycloplegics;
without holding a certificate issued under this chapter. These
pharmaceutical agents may be applied in diagnostic procedures only as
a part of an examination of the eye.
(b) The board may authorize an optometrist holding a certificate
issued under section 12(a) of this chapter to:
(1) administer for therapeutic use;
(2) dispense; or
(3) prescribe;
legend drugs that are included in the formulary established by the
board under section 10 of this chapter, in the treatment of any condition
of the eye or the associated structures of the eye.
(c) The board may authorize an optometrist holding a certificate
issued under section 12(b) of this chapter to:
(1) administer for therapeutic use;
(2) dispense; or
(3) prescribe;
a narcotic drug described in section 6(a) of this chapter that is
included in the formulary established by the board under section
10 of this chapter, in the treatment of any condition of the eye or
the associated structures of the eye.
SOURCE: IC 25-24-3-17; (07)EH1349.1.6. -->
SECTION 6. IC 25-24-3-17, AS ADDED BY P.L.157-2006,
SECTION 65, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2007]: Sec. 17. (a) An optometrist may not:
(1) administer, dispense, or prescribe therapeutic legend drugs; or
(2) dispense or prescribe diagnostic legend drugs, narcotic drugs
described in section 6(a) of this chapter;
unless the optometrist is certified under this chapter.
(b) An optometrist may not prescribe or dispense for a patient
more than a forty-eight (48) hour supply, and not more than twelve
(12) doses of a narcotic drug described in section 6(a) of this
chapter for treatment of a single acute:
(1) episode;
(2) condition; or
(3) injury.
Before an optometrist may prescribe or dispense for a patient a
drug described in this subsection, the optometrist must examine the
patient. The optometrist may prescribe or dispense a drug
described in this subsection only:
(1) in writing; and
(2) for treatment of the eye.
If the patient's pain does not improve after forty-eight (48) hours,
the optometrist shall refer the patient to a physician licensed under
IC 25-22.5.
(b) (c) An optometrist may administer diagnostic legend drugs
without obtaining a certificate under this chapter.
(c) (d) An individual who recklessly, knowingly, or intentionally
violates this chapter commits a Class A misdemeanor.
SOURCE: IC 35-48-2-1; (07)EH1349.1.7. -->
SECTION 7. IC 35-48-2-1 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 1. (a) The board shall
administer this article and may recommend to the general assembly the
addition, deletion, or rescheduling of all substances listed in the
schedules in sections 4, 6, 8, 10, and 12 of this chapter by submitting
in an electronic format under IC 5-14-6 a report of such
recommendations to the legislative council. In making a determination
regarding a substance, the board shall consider the following:
(1) The actual or relative potential for abuse.
(2) The scientific evidence of its pharmacological effect, if
known.
(3) The state of current scientific knowledge regarding the
substance.
(4) The history and current pattern of abuse.
(5) The scope, duration, and significance of abuse.
(6) The risk to public health.
(7) The potential of the substance to produce psychic or
physiological dependence liability.
(8) Whether the substance is an immediate precursor of a
substance already controlled under this article.
(b) After considering the factors enumerated in subsection (a), the
board shall make findings and recommendations concerning the control
of the substance if it finds the substance has a potential for abuse.
(c) If the board finds that a substance is an immediate precursor,
substances which are precursors of the controlled precursor shall not
be subject to control solely because they are precursors of the
controlled precursor.
(d) If any substance is designated or rescheduled to a more
restrictive schedule as a controlled substance under federal law and
notice is given to the board, the board shall recommend similar control
of the substance under this article in the board's report to the general
assembly, unless the board objects to inclusion or rescheduling. In that
case, the board shall publish the reasons for objection and afford all
interested parties an opportunity to be heard. At the conclusion of the
hearing, the board shall publish its findings.
(e) If a substance is rescheduled to a less restrictive schedule or
deleted as a controlled substance under federal law, the substance is
rescheduled or deleted under this article. If the board objects to
inclusion, rescheduling, or deletion of the substance, the board shall
notify the chairman of the legislative council not more than thirty (30)
days after the federal law is changed and the substance may not be
rescheduled or deleted until the conclusion of the next complete
session of the general assembly. The notice from the board to the
chairman of the legislative council must be published.
(f) There is established a
sixteen (16) seventeen (17) member
controlled substances advisory committee to serve as a consultative and
advising body to the board in all matters relating to the classification,
reclassification, addition to, or deletion from of all substances
classified as controlled substances in schedules I to IV or substances
not controlled or yet to come into being. In addition, the advisory
committee shall conduct hearings and make recommendations to the
board regarding revocations, suspensions, and restrictions of
registrations as provided in IC 35-48-3-4. All hearings shall be
conducted in accordance with IC 4-21.5-3. The advisory committee
shall be made up of:
(1) two (2) physicians licensed under IC 25-22.5, one (1) to be
elected by the medical licensing board of Indiana from among its
members and one (1) to be appointed by the governor;
(2) two (2) pharmacists, one (1) to be elected by the state board
of pharmacy from among its members and one (1) to be appointed
by the governor;
(3) two (2) dentists, one (1) to be elected by the state board of
dentistry from among its members and one (1) to be appointed by
the governor;
(4) the state toxicologist or the designee of the state toxicologist;
(5) two (2) veterinarians, one (1) to be elected by the state board
of veterinary medical examiners from among its members and one
(1) to be appointed by the governor;
(6) one (1) podiatrist to be elected by the board of podiatric
medicine from among its members;
(7) one (1) advanced practice nurse with authority to prescribe
legend drugs as provided by IC 25-23-1-19.5 who is:
(A) elected by the state board of nursing from among the
board's members; or
(B) if a board member does not meet the requirements under
IC 25-23-1-19.5 at the time of the vacancy on the advisory
committee, appointed by the governor;
(8) the superintendent of the state police department or the
superintendent's designee;
(9) three (3) members appointed by the governor who have
demonstrated expertise concerning controlled substances; and
(10) one (1) member appointed by the governor who is a
psychiatrist with expertise in child and adolescent psychiatry; and
(11) one (1) optometrist to be elected by the Indiana
optometry board from among its members.
(g) All members of the advisory committee elected by a board shall
serve a term of one (1) year and all members of the advisory committee
appointed by the governor shall serve a term of four (4) years. Any
elected or appointed member of the advisory committee, may be
removed for cause by the authority electing or appointing the member.
If a vacancy occurs on the advisory committee, the authority electing
or appointing the vacating member shall elect or appoint a successor to
serve the unexpired term of the vacating member. The board shall
acquire the recommendations of the advisory committee pursuant to
administration over the controlled substances to be or not to be
included in schedules I to V, especially in the implementation of
scheduled substances changes as provided in subsection (d).
(h) Authority to control under this section does not extend to
distilled spirits, wine, or malt beverages, as those terms are defined or
used in IC 7.1, or to tobacco.
(i) The board shall exclude any nonnarcotic substance from a
schedule if that substance may, under the Federal Food, Drug, and
Cosmetic Act or state law, be sold over the counter without a
prescription.
SOURCE: IC 35-48-2-1.5; (07)EH1349.1.8. -->
SECTION 8. IC 35-48-2-1.5, AS AMENDED BY P.L.1-2006,
SECTION 546, IS AMENDED TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2007]: Sec. 1.5. (a) The advisory committee
shall annually elect a chairperson and any other officers that the
advisory committee determines necessary from among its members.
(b) Meetings of the advisory committee may be called by:
(1) the advisory committee chairperson; or
(2) a majority of the members of the advisory committee.
(c)
Seven (7) Nine (9) members of the
advisory committee
constitute a quorum.
(d) Notwithstanding IC 1-1-4-1, if at least a quorum of its members
are present at a meeting, the
advisory committee may take an action by
an affirmative vote of
at least a majority of the members.
present and
voting.
(e) The advisory committee shall adopt rules under IC 4-22-2 to:
(1) set standards related to the registration and control of the
manufacture, distribution, and dispensing of controlled
substances, including record keeping requirements;
(2) set fees described in IC 25-1-8; and
(3) carry out its responsibilities under IC 35-48-2 through
IC 35-48-3.
(f) The Indiana professional licensing agency shall provide staff and
facilities to the advisory committee under IC 25-1-5.
(g) Each member of the
advisory committee who is not a state
employee is entitled to the minimum salary per diem provided by
IC 4-10-11-2.1(b).
Such a The member is also entitled to
reimbursement for traveling expenses and other expenses actually
incurred in connection with the member's duties, as provided in the
state travel policies and procedures established by the department of
administration and approved by the budget agency.
(h) Each member of the
advisory committee who is a state
employee is entitled to reimbursement for traveling expenses and other
expenses actually incurred in connection with the member's duties, as
provided in the state travel policies and procedures established by the
department of administration and approved by the budget agency.
SOURCE: IC 25-24-3-11; (07)EH1349.1.9. -->
SECTION 9. IC 25-24-3-11 IS REPEALED [EFFECTIVE JULY 1,
2007].