HB1226 (2016) Detail

Relative to administration of pharmaceutical agents by optometrists.


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CHAPTER 83

HB 1226 - FINAL VERSION

9Mar2016... 0136h

2016 SESSION

\t16-2430

\t10/05

 

HOUSE BILL\t1226

 

AN ACT\trelative to administration of pharmaceutical agents by optometrists.

 

SPONSORS:\tRep. Hoell, Merr. 23; Rep. Itse, Rock. 10; Rep. Parker, Carr. 6; Rep. Cilley, Straf. 4; Sen. Soucy, Dist 18; Sen. Carson, Dist 14; Sen. Reagan, Dist 17

 

COMMITTEE:\tExecutive Departments and Administration

 

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ANALYSIS

 

\tThis bill allows the board of optometry to review and approve certain pharmaceutical agents for use by optometrists and changes the name of the joint pharmaceutical formulary and credentialing committee.

 

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Explanation:\tMatter added to current law appears in bold italics.

\t\tMatter removed from current law appears [in brackets and struckthrough.]

\t\tMatter which is either (a) all new or (b) repealed and reenacted appears in regular type.

9Mar2016... 0136h\t16-2430

\t10/05

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Sixteen

 

AN ACT\trelative to administration of pharmaceutical agents by optometrists.

 

Be it Enacted by the Senate and House of Representatives in General Court convened:

 

\t83:1  Optometry; Definition; Pharmaceutical Agent.  Amend RSA 327:1, III(j) and (k) to read as follows:

\t\t\t(j)  Non-steroidal anti-inflammatory agents approved pursuant to RSA 327:6-a, VI [and included in the formulary].

\t\t\t(k)  Anti-glaucoma agents [which are topically applied] provided that an optometrist may dispense or prescribe such agents if the optometrist has met the requirements of RSA 327:6-c.

\t83:2  Optometry; Authorization for Pharmaceutical Agents.  Amend RSA 327:6-a, IV and V to read as follows:

\t\tIV.  Nothing in this section shall be construed to permit an optometrist to administer any pharmaceutical product by [intravenous] injection; or to administer, prescribe or dispense any pharmaceutical product designated as a [category] schedule I or schedule II controlled substance [defined by the United States Controlled Substances Act of 1970, as amended] under RSA 318-B:1-a; or to administer, prescribe or dispense any pharmaceutical product except for the diagnosis or treatment of disease or conditions of the human eye, adnexa or eyelids.

\t\tV.  Notwithstanding any other provision of law, an optometrist who is certified to use pharmaceutical agents in the practice of optometry shall be permitted to administer diphenhydramine, epinephrine or an equivalent medication administered by injection to counter anaphylaxis or anaphylactic reaction.

\t83:3  Approval of Pharmaceuticals.  Amend RSA 327:6-a, VI to read as follows:

\t\tVI.  To the extent approval of pharmaceuticals is referenced in RSA 327:1, III, the board shall have the authority to review and approve [topically applied pharmaceuticals and the joint pharmaceutical formulary and credentialing committee shall have the authority to review and approve orally administered] pharmaceuticals for use by optometrists certified to use pharmaceutical agents in the practice of optometry.

\t83:4  Joint Credentialing Committee.  Amend the section heading of RSA 327:6-b and RSA 327:6-b, I to read as follows:

\t327:6-b  Joint [Pharmaceutical Formulary and] Credentialing Committee.  

\t\tI.  The joint [pharmaceutical formulary and] credentialing committee shall be comprised of 3 optometrists licensed under RSA 327 appointed by the New Hampshire Optometric Association, 3 ophthalmologists licensed under RSA 329 appointed by the New Hampshire Society of Eye Physicians and Surgeons, and 3 pharmacists licensed under RSA 318 appointed by the pharmacy board.  Members shall serve terms of 5 years and shall not be eligible for a second consecutive term.  The initial members shall be appointed for staggered terms as follows: one optometrist, one ophthalmologist, and one pharmacist for a term of 5 years; one optometrist, one ophthalmologist, and one pharmacist for a term of 4 years; and one optometrist, one ophthalmologist, and one pharmacist for a term of 3 years.  All members shall be residents of the state of New Hampshire.  Neither they nor their spouses shall have any material financial interest in the provision of eye care services other than that which is directly related to the practice of their professions.  Matters to be brought before the committee shall be filed in writing with the chairperson at least 30 days prior to the scheduled meeting.  Any member of the committee may submit items to be assigned to the agenda for consideration.  Agendas shall be posted on the board of optometry's public access Internet site at least 10 days prior to committee meetings.

\t83:5  Treatment of Glaucoma; Joint Credentialing Committee.  Amend RSA 327:6-c, II and III to read as follows:

\t\tII.(a)  To be authorized to initiate treatment of glaucoma for patients 18 years of age or older, a therapeutic pharmaceutical agent certified optometrist shall complete the educational requirements in paragraph I and provide evidence of written referrals and consultations with an ophthalmologist.  For purposes of this section, "glaucoma'' means primary open-angle glaucoma; and "ophthalmologist''; means a physician licensed under RSA 329 with a specialty in ophthalmology.  The joint [pharmaceutical formulary and] credentialing committee shall review evidence of glaucoma co-management submitted pursuant to subparagraph (b).

\t\t\t(b)  Except as provided in subparagraph I(c) or paragraph III, therapeutic pharmaceutical agent certified optometrists are required to provide evidence of successful collaborative treatment and co-management of 25 glaucoma patients, up to 5 of which may be established patients, during a period of not less than 18 months for each patient, to ophthalmologists according to the following criteria:

\t\t\t\t(1)  A new or existing glaucoma patient is examined and diagnosed by the optometrist;

\t\t\t\t(2)  The optometrist develops a proposed treatment plan and forwards the plan with examination documentation to an ophthalmologist for consultation;

\t\t\t\t(3)  The ophthalmologist examines the patient and reviews the optometrist's examination documentation and proposed treatment plan;

\t\t\t\t(4)  The ophthalmologist, optometrist, and patient mutually agree to and document a treatment plan;

\t\t\t\t(5)  The optometrist shall consult with the co-managing ophthalmologist when any of the following occurs: the patient's target pressure is not reached within 90 days; the patient is experiencing documented progression of optic nerve damage; the patient develops documented and repeated progression of visual field loss; or the patient develops angle-closure or other secondary glaucoma; and

\t\t\t\t(6)  For each successfully co-managed glaucoma patient the optometrist and co-managing ophthalmologist shall complete a glaucoma credentialing reporting form and submit the form to the joint [pharmaceutical formulary and] credentialing committee upon completion of the 18 months of treatment.

\t\tIII.  The joint [pharmaceutical formulary and] credentialing committee may waive or reduce the requirements of RSA 327:6-c, I and II for the following categories of optometrists:

\t\t\t(a)  Optometrists with a license and proof of practice for 12 months treating glaucoma patients in another state that currently authorizes the treatment of glaucoma by optometrists; or

\t\t\t(b)  Optometrists who have proof of successful completion of a 12-month accredited optometric residency program or its equivalent.

\t83:6  Treatment of Glaucoma; Topical Medical Therapy.  Amend RSA 327:6-c, IV(b)(1) to read as follows:

\t\t\t\t(1)  The patient is experiencing documented progression of optic nerve damage or the patient develops documented and repeated progression of visual field loss on maximum tolerated topical medical therapy; or

\t83:7  Optometrists; Disciplinary Action; Reference Changed.  Amend RSA 327:20, II(i) to read as follows:

\t\t\t(i)  The use of any pharmaceutical agent by an optometrist not authorized under RSA 327:6-a or the use of any pharmaceutical agent other than those agents described in RSA 327:1 or those previously approved by the joint [pharmaceutical formulary and] credentialing committee.

\t83:8  Effective Date.  This act shall take effect 60 days after its passage.

Approved: May 19, 2016

Effective Date: July 18, 2016