By: Hancock S.B. No. 993
(In the Senate - Filed March 3, 2021; March 18, 2021, read
first time and referred to Committee on Business & Commerce;
May 10, 2021, reported adversely, with favorable Committee
Substitute by the following vote: Yeas 7, Nays 0; May 10, 2021,
sent to printer.)
Click here to see the committee vote
COMMITTEE SUBSTITUTE FOR S.B. No. 993 By: Hancock
A BILL TO BE ENTITLED
AN ACT
relating to the practice of therapeutic optometry.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter E, Chapter 351, Occupations Code, is
amended by adding Section 351.2034 to read as follows:
Sec. 351.2034. COMPLAINTS RESULTING FROM GLAUCOMA
TREATMENT. (a) The board, in collaboration with the Texas Medical
Board, shall adopt rules for investigating and reviewing complaints
filed with the board regarding a therapeutic optometrist's
treatment of a patient for glaucoma. The rules must ensure that:
(1) a person who files a complaint has the opportunity
to explain the allegations made in the complaint;
(2) a complaint is not dismissed without appropriate
consideration by the board;
(3) a complaint is resolved within six months after
the date the complaint is filed;
(4) the board notifies the Texas Medical Board of the
receipt and disposition of a complaint; and
(5) a complaint is reviewed as provided by this
section.
(b) After a complaint regarding a therapeutic optometrist's
treatment of a patient for glaucoma is filed with the board, the
board shall select at least one physician licensed in this state who
specializes in ophthalmology to:
(1) review the complaint and determine if the
therapeutic optometrist's treatment of the patient for glaucoma
violated the standard of care applicable to a physician
specializing in ophthalmology; and
(2) submit to the board a written report on the
physician's determination.
(c) If the report under Subsection (b) states that the
standard of care was violated, the board shall forward the
complaint and report to an expert panel appointed by the board and
the Texas Medical Board. The panel must be composed of an equal
number of physicians who specialize in ophthalmology and
therapeutic optometrists. Each member of the expert panel must be
licensed to practice medicine or therapeutic optometry, as
applicable, in this state. A physician who serves on an expert
panel may also serve as an expert physician for the Texas Medical
Board.
(d) An expert panel selected to review a complaint under
Subsection (c) shall:
(1) review the physician's determination made under
Subsection (b); and
(2) recommend to the board whether the therapeutic
optometrist should be subject to disciplinary action and, if so,
whether the disciplinary action should include suspension or
revocation of the therapeutic optometrist's certificate issued
under Section 351.3581(a).
(e) A person is not eligible to review a complaint under
Subsection (b) or serve on an expert panel under Subsection (c) if:
(1) the person or the person's spouse is an officer,
employee, or paid consultant of a Texas trade association, as
defined by Section 351.053, in the field of health care; or
(2) the person is a member of the faculty or board of
trustees of an optometry school or an institution of higher
education with an affiliated school of optometry.
(f) The board shall maintain and make publicly available
online:
(1) information regarding the number of complaints
filed with the board regarding the treatment of patients for
glaucoma by therapeutic optometrists and the disposition of those
complaints; and
(2) a searchable list of each therapeutic optometrist
whose certificate under Section 351.3581(a) was suspended or
revoked by the board.
(g) This section expires September 1, 2027.
SECTION 2. Section 351.358(c), Occupations Code, is amended
to read as follows:
(c) A therapeutic optometrist may prescribe not more than
[oral medications only in the following classifications of oral
pharmaceuticals:
[(1) one 10-day supply of oral antibiotics;
[(2) one 72-hour supply of oral antihistamines;
[(3) one seven-day supply of oral nonsteroidal
anti-inflammatories;
[(4)] one three-day supply of any medication
classified as a controlled substance under Schedule [analgesic
identified in Schedules] III, IV, or [and] V of 21 U.S.C. Section
812[; and
[(5) any other oral pharmaceutical recommended by the
Optometric Health Care Advisory Committee and approved by the board
and the Texas State Board of Medical Examiners].
SECTION 3. The heading to Section 351.3581, Occupations
Code, is amended to read as follows:
Sec. 351.3581. [DIAGNOSIS AND] TREATMENT OF GLAUCOMA.
SECTION 4. Sections 351.3581(a) and (d), Occupations Code,
are amended to read as follows:
(a) A therapeutic optometrist may not administer or
prescribe an oral or parenteral medication or treat glaucoma unless
the therapeutic optometrist holds a certificate issued by the
board. A therapeutic optometrist certified under this section
[subsection] shall be known as an optometric glaucoma specialist.
To obtain a certificate, a therapeutic optometrist must [as
required under Section 351.165(c)]:
(1) complete an instructional clinical review course;
and
(2) pass an examination approved by the board.
(d) A therapeutic optometrist shall refer a patient to an
ophthalmologist if:
(1) the patient is younger than 16 years of age and has
been diagnosed as having glaucoma;
(2) the patient has been diagnosed as having acute
closed angle glaucoma;
(3) the patient has been diagnosed as having malignant
glaucoma or neovascular glaucoma;
(4) the patient has definite optic disc, retinal nerve
fiber layer, or macular imaging abnormalities consistent with
glaucoma and visual field abnormalities in both hemifields, or loss
within five degrees of fixation in at least one hemifield as tested
with standard automated perimetry [therapeutic optometrist
determines that a patient's glaucoma is caused by a diabetic
complication and, after joint consultation with the physician
treating the diabetes and an ophthalmologist by telephone, fax, or
another method, the physician or ophthalmologist determines that
the patient should be seen by the physician or ophthalmologist]; or
(5) the therapeutic optometrist determines that a
patient's glaucoma is not responding [appropriately] to
nonsurgical intervention [a treatment specified in Subsection (f)
and, after consulting a physician by telephone, fax, or another
method, the physician determines that the patient should be seen by
the physician or an appropriate specialist].
SECTION 5. Not later than December 1, 2021, the Texas
Optometry Board shall adopt rules necessary to implement the
changes in law made by this Act to Chapter 351, Occupations Code.
SECTION 6. Sections 351.3581(b) and (c), Occupations Code,
are repealed.
SECTION 7. This Act takes effect September 1, 2021.
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