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