1.1                          A bill for an act 
  1.2             relating to occupations and professions; removing the 
  1.3             restriction of prescribing only topical legend drugs 
  1.4             by board certified optometrists; requiring that legend 
  1.5             drugs be used as included in optometry curricula; 
  1.6             authorizing the prescription of certain controlled 
  1.7             substances; amending reporting requirement of health 
  1.8             professionals to include all legend drugs; requiring 
  1.9             optometrists using legend drugs be held to the same 
  1.10            standards as physicians; amending Minnesota Statutes 
  1.11            2002, sections 147.111, subdivision 4; 148.574; 
  1.12            148.575, subdivisions 1, 2; 148.576; 148.577; 151.37, 
  1.13            subdivision 11; 152.11, subdivision 2; 152.12, 
  1.14            subdivisions 1, 4. 
  1.15  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  1.16     Section 1.  Minnesota Statutes 2002, section 147.111, 
  1.17  subdivision 4, is amended to read: 
  1.18     Subd. 4.  [LICENSED PROFESSIONALS.] A licensed health 
  1.19  professional and persons holding a residency permit under 
  1.20  section 147.0391, shall report to the board personal knowledge 
  1.21  of any conduct which the person reasonably believes constitutes 
  1.22  grounds for disciplinary action under sections 147.01 to 147.22 
  1.23  by any physician or person holding a residency permit under 
  1.24  section 147.0391, including any conduct indicating that the 
  1.25  person may be medically incompetent, or may have engaged in 
  1.26  unprofessional conduct or may be medically or physically unable 
  1.27  to engage safely in the practice of medicine.  A licensed 
  1.28  physician or other health professional licensed under this 
  1.29  chapter shall also report to the board any occurrence of any 
  1.30  adverse reaction resulting from an optometrist's prescription, 
  2.1   use, or administration of any topical legend drug.  Any reports 
  2.2   received by the board must be reported to the board of 
  2.3   optometry.  No report shall be required if the information was 
  2.4   obtained in the course of a physician-patient relationship if 
  2.5   the patient is a physician or person holding a residency permit 
  2.6   under section 147.0391, and the treating physician successfully 
  2.7   counsels the person to limit or withdraw from practice to the 
  2.8   extent required by the impairment. 
  2.9      Sec. 2.  Minnesota Statutes 2002, section 148.574, is 
  2.10  amended to read: 
  2.11     148.574 [PROHIBITIONS RELATING TO LEGEND DRUGS; AUTHORIZING 
  2.12  SALES BY PHARMACISTS UNDER CERTAIN CONDITIONS.] 
  2.13     An optometrist shall not purchase, possess, administer, 
  2.14  prescribe or give any legend drug as defined in section 151.01 
  2.15  or 152.02 to any person except as is expressly authorized by 
  2.16  sections 148.571 to 148.577.  The authorizations in sections 
  2.17  148.571 to 148.577 apply only to topical legend drugs.  Nothing 
  2.18  in chapter 151 shall prevent a pharmacist from selling topical 
  2.19  ocular drugs to an optometrist authorized to use such drugs 
  2.20  according to sections 148.571 to 148.577.  Notwithstanding 
  2.21  section sections 151.37 and 152.12, an optometrist is prohibited 
  2.22  from dispensing legend drugs at retail. 
  2.23     Sec. 3.  Minnesota Statutes 2002, section 148.575, 
  2.24  subdivision 1, is amended to read: 
  2.25     Subdivision 1.  [CERTIFICATE REQUIRED FOR USE OF TOPICAL 
  2.26  LEGEND DRUGS.] A licensed optometrist must be board certified to 
  2.27  use topical legend drugs for therapy under section 148.576. 
  2.28     Sec. 4.  Minnesota Statutes 2002, section 148.575, 
  2.29  subdivision 2, is amended to read: 
  2.30     Subd. 2.  [BOARD CERTIFIED DEFINED.] "Board certified" 
  2.31  means that a licensed optometrist has been issued a certificate 
  2.32  by the board of optometry certifying that the optometrist has 
  2.33  complied with the following requirements for the use of topical 
  2.34  legend drugs described in section 148.576: 
  2.35     (1) successful completion of at least 60 hours of study in 
  2.36  general and ocular pharmacology emphasizing drugs used for 
  3.1   examination or treatment purposes, their systemic effects and 
  3.2   management or referral of adverse reactions; 
  3.3      (2) successful completion of at least 100 hours of study in 
  3.4   the examination, diagnosis, and treatment of conditions of the 
  3.5   human eye with topical legend drugs; 
  3.6      (3) successful completion of two years of supervised 
  3.7   clinical experience in differential diagnosis of eye disease or 
  3.8   disorders as part of optometric training or one year of that 
  3.9   experience and ten years of actual clinical experience as a 
  3.10  licensed optometrist; and 
  3.11     (4) successful completion of a nationally standardized 
  3.12  examination approved by the board on the subject of treatment 
  3.13  and management of ocular disease prepared, administered, and 
  3.14  graded by the International Association of Boards of Examiners 
  3.15  in Optometry or an equivalent national board examination. 
  3.16     Sec. 5.  Minnesota Statutes 2002, section 148.576, is 
  3.17  amended to read: 
  3.18     148.576 [USE OF TOPICAL LEGEND DRUGS; LIMITATIONS; 
  3.19  REPORTS.] 
  3.20     Subdivision 1.  [AUTHORITY TO PRESCRIBE OR ADMINISTER.] A 
  3.21  licensed optometrist who is board certified under section 
  3.22  148.575 may prescribe or administer topical legend drugs to aid 
  3.23  in the diagnosis, cure, mitigation, prevention, treatment, or 
  3.24  management of disease, deficiency, deformity, or abnormality of 
  3.25  the human eye and adnexa included in the curricula of accredited 
  3.26  schools or colleges of optometry.  Nothing in this section shall 
  3.27  allow (1) legend drugs to be administered intravenously, 
  3.28  intramuscularly, or by injection except for treatment of 
  3.29  anaphylaxis, (2) invasive surgery including, but not limited to, 
  3.30  surgery using lasers, (3) schedule II and III oral legend drugs 
  3.31  and oral steroids to be administered or prescribed, (4) oral 
  3.32  antivirals to be prescribed or administered for more than ten 
  3.33  days, or (5) oral carbonic anhydrase inhibitors to be prescribed 
  3.34  or administered for more than seven days.  
  3.35     Subd. 2.  [ADVERSE REACTION REPORTS.] An optometrist 
  3.36  certified to prescribe topical legend drugs shall file with the 
  4.1   board of optometry within ten working days of its occurrence a 
  4.2   report on any adverse reaction resulting from the optometrist's 
  4.3   administration of a drug.  The report must include the 
  4.4   optometrist's name, address, and license number; the patient's 
  4.5   name, address, and age; the patient's presenting problem; the 
  4.6   diagnosis; the agent administered and the method of 
  4.7   administration; the reaction; and the subsequent action taken. 
  4.8      Sec. 6.  Minnesota Statutes 2002, section 148.577, is 
  4.9   amended to read: 
  4.10     148.577 [STANDARD OF CARE.] 
  4.11     A licensed optometrist who is board certified under section 
  4.12  148.575 is held to the same standard of care in the use of those 
  4.13  legend drugs as physicians licensed by the state of Minnesota. 
  4.14     Sec. 7.  Minnesota Statutes 2002, section 151.37, 
  4.15  subdivision 11, is amended to read: 
  4.16     Subd. 11.  [COMPLAINT REPORTING.] The board of pharmacy 
  4.17  shall report on a quarterly basis to the board of optometry any 
  4.18  complaints received regarding the prescription or administration 
  4.19  of topical legend drugs under section 148.576. 
  4.20     Sec. 8.  Minnesota Statutes 2002, section 152.11, 
  4.21  subdivision 2, is amended to read: 
  4.22     Subd. 2.  [WRITTEN OR ORAL PRESCRIPTION REQUIREMENT FOR 
  4.23  SCHEDULE III OR IV CONTROLLED SUBSTANCES.] No person may 
  4.24  dispense a controlled substance included in schedule III or IV 
  4.25  of section 152.02 without a written or oral prescription from a 
  4.26  doctor of medicine, a doctor of osteopathy licensed to practice 
  4.27  medicine, a doctor of dental surgery, a doctor of dental 
  4.28  medicine, a doctor of podiatry, a doctor of optometry limited to 
  4.29  schedule IV, or a doctor of veterinary medicine, lawfully 
  4.30  licensed to prescribe in this state or a state bordering 
  4.31  Minnesota, and having a current federal drug enforcement 
  4.32  administration registration number.  Such prescription may not 
  4.33  be dispensed or refilled except with the written or verbal 
  4.34  consent of the prescriber, and in no event more than six months 
  4.35  after the date on which such prescription was issued and no such 
  4.36  prescription may be refilled more than five times. 
  5.1      Sec. 9.  Minnesota Statutes 2002, section 152.12, 
  5.2   subdivision 1, is amended to read: 
  5.3      Subdivision 1.  [PRESCRIBING, DISPENSING, ADMINISTERING 
  5.4   CONTROLLED SUBSTANCES IN SCHEDULES II THROUGH V.] A licensed 
  5.5   doctor of medicine, a doctor of osteopathy, duly licensed to 
  5.6   practice medicine, a doctor of dental surgery, or a doctor of 
  5.7   dental medicine, or a licensed doctor of podiatry, or a licensed 
  5.8   doctor of optometry limited to schedules IV and V, and in the 
  5.9   course of professional practice only, may prescribe, administer, 
  5.10  and dispense a controlled substance included in Schedules II 
  5.11  through V of section 152.02, may cause the same to be 
  5.12  administered by a nurse, an intern or an assistant under the 
  5.13  direction and supervision of the doctor, and may cause a person 
  5.14  who is an appropriately certified and licensed health care 
  5.15  professional to prescribe and administer the same within the 
  5.16  expressed legal scope of the person's practice as defined in 
  5.17  Minnesota Statutes. 
  5.18     Sec. 10.  Minnesota Statutes 2002, section 152.12, 
  5.19  subdivision 4, is amended to read: 
  5.20     Subd. 4.  [SALE OF CONTROLLED SUBSTANCES NOT PROHIBITED FOR 
  5.21  CERTAIN PERSONS AND ENTITIES.] Nothing in this chapter shall 
  5.22  prohibit the sale to, or the possession of, a controlled 
  5.23  substance in schedule II, III, IV or V by:  Registered drug 
  5.24  wholesalers, registered manufacturers, registered pharmacies, or 
  5.25  any licensed hospital or other licensed institutions wherein 
  5.26  sick and injured persons are cared for or treated, or bona fide 
  5.27  hospitals wherein animals are treated; or by licensed 
  5.28  pharmacists, licensed doctors of medicine, doctors of osteopathy 
  5.29  duly licensed to practice medicine, licensed doctors of dental 
  5.30  surgery, licensed doctors of dental medicine, licensed doctors 
  5.31  of podiatry, licensed doctors of optometry limited to schedules 
  5.32  IV and V, or licensed doctors of veterinary medicine when such 
  5.33  practitioners use controlled substances within the course of 
  5.34  their professional practice only. 
  5.35     Nothing in this chapter shall prohibit the possession of a 
  5.36  controlled substance in schedule II, III, IV or V by an employee 
  6.1   or agent of a registered drug wholesaler, registered 
  6.2   manufacturer, or registered pharmacy, while acting in the course 
  6.3   of employment, or; by a patient of a licensed doctor of 
  6.4   medicine, a doctor of osteopathy duly licensed to practice 
  6.5   medicine, or a licensed doctor of dental surgery, a licensed 
  6.6   doctor of dental medicine, or a licensed doctor of optometry 
  6.7   limited to schedules IV and V; or by the owner of an animal for 
  6.8   which a controlled substance has been prescribed by a licensed 
  6.9   doctor of veterinary medicine, when such controlled substances 
  6.10  are dispensed according to law.