Texas 2015 - 84th Regular

Texas Senate Bill SB577 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	84R7368 NC-F
2	2	By: Perry S.B. No. 577
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the practice of therapeutic optometry.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Sections 351.358(b), (c), (d), and (e),
10	10	Occupations Code, are amended to read as follows:
11	11	(b) A therapeutic optometrist may:
12	12	(1) administer, perform, or prescribe ophthalmic
13	13	devices, procedures, and appropriate medications administered by
14	14	topical or oral means[, in accordance with this section and Section
15	15	351.3581,] to diagnose or treat visual defects, abnormal
16	16	conditions, or diseases of the human vision system, including the
17	17	eye and adnexa; or
18	18	(2) administer medication by parenteral means for a
19	19	purpose and in a manner prescribed by Subsection (d) [(e)].
20	20	(c) A therapeutic optometrist may administer or prescribe
21	21	oral analgesics [medications] only in the following
22	22	classifications of oral pharmaceuticals:
23	23	(1) [one 10-day supply of oral antibiotics;
24	24	[(2) one 72-hour supply of oral antihistamines;
25	25	[(3) one seven-day supply of oral nonsteroidal
26	26	anti-inflammatories;
27	27	[(4)] one three-day supply of any analgesic classified
28	28	as a controlled substance under Schedule [identified in Schedules]
29	29	III, IV, or [and] V of 21 U.S.C. Section 812; and
30	30	(2) one three-day supply of hydrocodone or of a
31	31	hydrocodone combination product classified as a controlled
32	32	substance under Schedule II of 21 U.S.C. Section 812
33	33	[(5) any other oral pharmaceutical recommended by the
34	34	Optometric Health Care Advisory Committee and approved by the board
35	35	and the Texas State Board of Medical Examiners].
36	36	(d) [A therapeutic optometrist may independently administer
37	37	oral carbonic anhydrase inhibitors for emergency purposes only and
38	38	shall immediately refer the patient to an ophthalmologist.
39	39	[(e)] A therapeutic optometrist may inject appropriate
40	40	medication for a patient who has an anaphylactic reaction to
41	41	counteract the anaphylaxis. The therapeutic optometrist shall
42	42	immediately refer the patient to a physician.
43	43	SECTION 2. Section 351.3581, Occupations Code, is amended
44	44	to read as follows:
45	45	Sec. 351.3581. [DIAGNOSIS AND] TREATMENT OF GLAUCOMA.
46	46	[(a)] A therapeutic optometrist may not administer or prescribe an
47	47	oral or parenteral medication or treat glaucoma unless the
48	48	therapeutic optometrist holds a certificate issued by the board. A
49	49	therapeutic optometrist certified under this section [subsection]
50	50	shall be known as an optometric glaucoma specialist. To obtain a
51	51	certificate, a therapeutic optometrist must [as required under
52	52	Section 351.165(c)]:
53	53	(1) complete an instructional clinical review course;
54	54	and
55	55	(2) pass an examination approved by the board.
56	56	[(b) Not later than the 30th day after the date of the
57	57	initial diagnosis of glaucoma, a therapeutic optometrist shall
58	58	engage in consultation with an ophthalmologist to develop an
59	59	individual treatment plan that is approved by the therapeutic
60	60	optometrist and ophthalmologist. The parameters of the
61	61	consultation shall be at the discretion of the ophthalmologist but
62	62	must at least include confirmation of the diagnosis and a plan for
63	63	comanagement of the patient, including periodic review of the
64	64	patient's progress.
65	65	[(c) A therapeutic optometrist required to engage in
66	66	comanagement consultation with an ophthalmologist shall inform the
67	67	patient diagnosed with glaucoma that the therapeutic optometrist is
68	68	required to have the diagnosis confirmed and comanaged with an
69	69	ophthalmologist of the patient's choosing or, if the patient does
70	70	not choose an ophthalmologist, an ophthalmologist practicing in the
71	71	geographic area in which the therapeutic optometrist practices.
72	72	[(d) A therapeutic optometrist shall refer a patient to an
73	73	ophthalmologist if:
74	74	[(1) the patient is younger than 16 years of age and
75	75	has been diagnosed as having glaucoma;
76	76	[(2) the patient has been diagnosed as having acute
77	77	closed angle glaucoma;
78	78	[(3) the patient has been diagnosed as having
79	79	malignant glaucoma or neovascular glaucoma;
80	80	[(4) the therapeutic optometrist determines that a
81	81	patient's glaucoma is caused by a diabetic complication and, after
82	82	joint consultation with the physician treating the diabetes and an
83	83	ophthalmologist by telephone, fax, or another method, the physician
84	84	or ophthalmologist determines that the patient should be seen by
85	85	the physician or ophthalmologist; or
86	86	[(5) the therapeutic optometrist determines that a
87	87	patient's glaucoma is not responding appropriately to a treatment
88	88	specified in Subsection (f) and, after consulting a physician by
89	89	telephone, fax, or another method, the physician determines that
90	90	the patient should be seen by the physician or an appropriate
91	91	specialist.
92	92	[(e) A therapeutic optometrist who refers a patient to a
93	93	physician or specialist shall inform the patient that the patient
94	94	may go to any physician or specialist the patient chooses. This
95	95	subsection does not prevent a therapeutic optometrist from
96	96	recommending a physician or specialist.
97	97	[(f) On making an initial diagnosis of glaucoma, a
98	98	therapeutic optometrist shall set a target pressure that is not
99	99	more than 80 percent of the initial intraocular pressure. The
100	100	patient's glaucoma is not considered to be appropriately responding
101	101	to treatment if the patient fails to achieve the target pressure
102	102	within an appropriate time.
103	103	[(g) Before a therapeutic optometrist may prescribe a beta
104	104	blocker, the therapeutic optometrist must take a complete case
105	105	history of the patient and determine whether the patient has had a
106	106	physical examination within the 180 days preceding the date of
107	107	taking the history. If the patient has not had a physical
108	108	examination or if the patient has a history of congestive heart
109	109	failure, bradycardia, heart block, asthma, or chronic obstructive
110	110	pulmonary disease, the therapeutic optometrist must refer the
111	111	patient to a physician for a physical examination before initiating
112	112	beta blocker therapy.
113	113	[(h) A therapeutic optometrist who diagnoses acute closed
114	114	angle glaucoma may initiate appropriate emergency treatment for a
115	115	patient but shall refer the patient to a physician in a timely
116	116	manner.
117	117	[(i) A physician may charge a reasonable consultation fee
118	118	for a consultation given as provided by this section.
119	119	[(j) A physician to whom a patient is referred by a
120	120	therapeutic optometrist under this section shall forward to the
121	121	therapeutic optometrist, not later than the 30th day after first
122	122	seeing the patient, a written report on the results of the referral.
123	123	The therapeutic optometrist shall maintain the report in the
124	124	patient's records. A physician who, for a medically appropriate
125	125	reason, does not return a patient to the therapeutic optometrist
126	126	who referred the patient shall state in the physician's report to
127	127	the therapeutic optometrist the specific medical reason for failing
128	128	to return the patient.]
129	129	SECTION 3. This Act takes effect September 1, 2015.