Assembly Bill No. 432–Committee on Commerce and Labor
March 10, 1999
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Referred to Committee on Commerce and Labor
SUMMARY—Revises provisions governing practice of optometry. (BDR 54-339)
FISCAL NOTE: Effect on Local Government: No.
Effect on the State or on Industrial Insurance: No.
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EXPLANATION – Matter in
bolded italics is new; matter between brackets
THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:
1-1
Section 1. Chapter 636 of NRS is hereby amended by adding thereto1-2
the provisions set forth as sections 2 to 5, inclusive, of this act.1-3
Sec. 2. An optometrist who is certified to administer and prescribe a1-4
therapeutic pharmaceutical agent pursuant to NRS 636.288 shall not1-5
prescribe an analgesic of hydrocodone with compounds, codeine with1-6
compounds or propoxyphene with compounds unless he:1-7
1. Has completed an optometric examination of the patient for whom1-8
the therapeutic pharmaceutical agent is prescribed;1-9
2. Prescribes the therapeutic pharmaceutical agent in an amount1-10
that will not last more than 72 hours; and1-11
3. Sets forth in the prescription for the therapeutic pharmaceutical1-12
agent that the prescription may not be refilled.1-13
Sec. 3. 1. An optometrist shall not treat a person diagnosed with1-14
glaucoma unless he has been issued a certificate by the board pursuant1-15
to section 5 of this act.2-1
2. An optometrist who has been issued a certificate to treat persons2-2
diagnosed with glaucoma pursuant to section 5 of this act shall refer a2-3
patient diagnosed with glaucoma to an ophthalmologist for treatment if2-4
any one of the following is applicable:2-5
(a) The patient is under 16 years of age.2-6
(b) The patient has been diagnosed with malignant glaucoma or2-7
neovascular glaucoma.2-8
(c) The patient has been diagnosed with acute closed angle glaucoma.2-9
The provisions of this paragraph do not prohibit the optometrist from2-10
administering appropriate emergency treatment to the patient.2-11
(d) The patient’s glaucoma is caused by diabetes, and, after joint2-12
consultation with a physician who is treating the diabetes and an2-13
ophthalmologist, the physician or ophthalmologist determines that the2-14
patient should be treated by an ophthalmologist. If an optometrist2-15
determines that a patient’s glaucoma is caused by diabetes, he shall2-16
consult with a physician and ophthalmologist in the manner provided in2-17
this paragraph. Sec. 4. The board shall adopt regulations that prescribe the2-19
requirements for the issuance of a certificate to treat persons diagnosed2-20
with glaucoma pursuant to section 5 of this act. The requirements must2-21
include, without limitation:2-22
1. A license to practice optometry in this state;2-23
2. The successful completion of the "Treatment and Management of2-24
Ocular Disease Examination" administered by the National Board of2-25
Examiners in Optometry on or after January 1, 1993, or an equivalent2-26
examination approved by the board; and2-27
3. Proof that each optometrist who applies for a certificate has2-28
treated at least 15 persons who were:2-29
(a) Diagnosed with glaucoma by an ophthalmologist licensed in this2-30
state; and2-31
(b) Treated by the optometrist, in consultation with that2-32
ophthalmologist, for at least 1 year. Sec. 5. The board shall issue a certificate to treat persons diagnosed2-34
with glaucoma to each optometrist who has complied with the2-35
requirements prescribed by the board pursuant to section 4 of this act.2-36
Sec. 6. NRS 636.022 is hereby amended to read as follows: 636.022 "Prescription" means2-38
1. An order given individually for the person for whom prescribed,2-39
directly from a licensed optometrist who is certified to prescribe and2-40
administer therapeutic pharmaceutical agents pursuant to NRS 636.288,2-41
or his agent, to a pharmacist or indirectly by means of an order signed by2-42
the licensed optometrist or an electronic transmission from the licensed2-43
optometrist to a pharmacist; or3-1
2. A written direction from a licensed optometrist to:3-2
3-3
3-4
adjustment, modification or fitting.3-5
Sec. 7. NRS 636.024 is hereby amended to read as follows: 636.024 "Therapeutic pharmaceutical agent" means3-7
1. A topical medication3-8
2. An oral antibiotic ;3-9
3. An oral medication for allergies that does not contain steroids; or3-10
4. An analgesic of hydrocodone with compounds, codeine with3-11
compounds or propoxyphene with compounds,3-12
approved by the Food and Drug Administration for the treatment of3-13
abnormalities of the eye or its appendages.3-14
Sec. 8. NRS 636.025 is hereby amended to read as follows: 636.025 1. The acts3-16
them, whether done severally, collectively or in combination with other acts3-17
that are not3-18
optometry within the purview of this chapter:3-19
(a) Advertisement or representation as an optometrist.3-20
(b) Adapting, or prescribing or dispensing, without prescription by a3-21
3-22
state, any ophthalmic lens, frame or mounting, or any part thereof, for3-23
correction, relief or remedy of any abnormal condition or insufficiency of3-24
the eye or any appendage or visual process .3-25
this subsection do not prevent an optical mechanic from doing the mere3-26
mechanical work of replacement or duplication of the ophthalmic lens or3-27
prevent a licensed dispensing optician from engaging in the practice of3-28
ophthalmic dispensing.3-29
(c) The examination of the human eye and its appendages, the3-30
measurement of the powers or range of human vision, the determination of3-31
the accommodative and refractive states of the eye or the scope of its3-32
function in general , or the diagnosis or determination of any visual,3-33
muscular, neurological, interpretative or anatomic anomalies or deficiencies3-34
of the eye or its appendages or visual processes.3-35
(d) Prescribing, directing the use of or using any optical device in3-36
connection with ocular exercises, orthoptics or visual training.3-37
(e) The prescribing of contact lenses.3-38
(f) The measurement, fitting or adaptation of contact lenses to the3-39
human eye except under the direction and supervision of a physician,3-40
surgeon or optometrist licensed in the State of Nevada.3-41
(g) The topical use of diagnostic pharmaceutical agents to determine any3-42
visual, muscular, neurological, interpretative or anatomic anomalies or3-43
deficiencies of the eye or its appendages or visual processes.4-1
(h) Prescribing, directing the use of or using a therapeutic4-2
pharmaceutical agent to treat an abnormality of the eye or its appendages.4-3
(i) Removing a foreign object from the surface or epithelium of the eye.4-4
(j) The ordering of laboratory tests to assist in the diagnosis of an4-5
abnormality of the eye or its appendages.4-6
2. The provisions of this section do not authorize an optometrist to4-7
engage in any practice which includes:4-8
(a) The incision or suturing of the eye or its appendages; or4-9
(b) The use of lasers for surgical purposes .4-10
4-11
Sec. 9. NRS 636.350 is hereby amended to read as follows: 636.3504-13
1. An optometrist shall not4-14
assumed or fictitious name4-15
registration by the board to practice optometry under an assumed or4-16
fictitious name.4-17
2. An optometrist who applies for a certificate of registration to4-18
practice optometry under an assumed or fictitious name must submit to4-19
the board an application on a form provided by the board.4-20
3. Each optometrist who is issued a certificate of registration4-21
pursuant to this section shall:4-22
(a) Comply with the provisions of chapter 602 of NRS; and4-23
(b) Display or cause to be displayed near the entrance of his business4-24
his full name and the words or letters that designate him as an4-25
optometrist.4-26
4. The board shall adopt regulations that prescribe the requirements4-27
for the issuance of a certificate of registration to practice optometry4-28
under an assumed or fictitious name.4-29
5. As used in this section, "assumed or fictitious name" means a4-30
name that is not the real name of each person who owns an interest in a4-31
business.4-32
Sec. 10. NRS 652.210 is hereby amended to read as follows: 652.210 No person other than a licensed physician, a licensed4-34
optometrist, a licensed practical nurse, a registered nurse, a licensed or4-35
certified physician’s assistant, a certified intermediate emergency medical4-36
technician, a certified advanced emergency medical technician or a licensed4-37
dentist may manipulate a person for the collection of specimens, except that4-38
technical personnel of a laboratory may collect blood, remove stomach4-39
contents, perform certain diagnostic skin tests or field blood tests or collect4-40
material for smears and cultures.5-1
Sec. 11. NRS 453.126 is hereby amended to read as follows: 453.126 "Practitioner" means:5-3
1. A physician, dentist, veterinarian or podiatric physician who holds a5-4
5-5
pursuant to this chapter.5-6
2. An advanced practitioner of nursing who holds a certificate from the5-7
state board of nursing and a certificate from the state board of pharmacy5-8
5-9
3. A scientific investigator or a pharmacy, hospital or other institution5-10
licensed, registered or otherwise5-11
distribute, dispense, conduct research with respect to, to administer, or use5-12
in teaching or chemical analysis, a controlled substance in the course of5-13
professional practice or research.5-14
4. A euthanasia technician who is licensed by the Nevada state board5-15
of veterinary medical examiners and registered pursuant to this chapter,5-16
5-17
his license and registration.5-18
5. A physician’s assistant who:5-19
(a) Holds a license from the board of medical examiners or a certificate5-20
from the state board of osteopathic medicine; and5-21
(b) Is authorized by the board to possess, administer, prescribe or5-22
dispense controlled substances under the supervision of a physician or5-23
osteopathic physician as required by chapter 630 or 633 of NRS.5-24
6. An optometrist who is certified by the Nevada state board of5-25
optometry to prescribe and administer therapeutic pharmaceutical agents5-26
pursuant to NRS 636.288, when he prescribes or administers therapeutic5-27
pharmaceutical agents within the scope of his certification.5-28
Sec. 12. NRS 453.128 is hereby amended to read as follows: 453.128 1. "Prescription" means:5-30
(a) An order given individually for the person for whom prescribed,5-31
directly from a physician, physician’s assistant, dentist, podiatric physician5-32
, optometrist or veterinarian, or his agent, to a pharmacist or indirectly by5-33
means of an order signed by the practitioner or an electronic transmission5-34
from the practitioner to a pharmacist5-35
(b) A chart order written for an inpatient specifying drugs which he is to5-36
take home upon his discharge.5-37
2.5-38
an inpatient for use while he is an inpatient.5-39
Sec. 13. NRS 453.336 is hereby amended to read as follows: 453.336 1.5-41
intentionally5-42
obtained directly from, or pursuant to, a5-43
physician, physician’s assistant, dentist, podiatric physician , optometrist6-1
or veterinarian while acting in the course of his professional practice, or6-2
except as otherwise authorized by the provisions of NRS 453.011 to6-3
453.552, inclusive.6-4
2. Except as otherwise provided in subsections 3, 4 and 5 and in NRS6-5
453.3363, and unless a greater penalty is provided in NRS 212.160,6-6
453.3385, 453.339 or 453.3395, a person who violates this section shall be6-7
punished:6-8
(a) For the first or second offense, if the controlled substance is listed in6-9
schedule I, II, III or IV, for a category E felony as provided in NRS6-10
193.130.6-11
(b) For a third or subsequent offense, if the controlled substance is listed6-12
in schedule I, II, III or IV, or if the offender has previously been convicted6-13
two or more times in the aggregate of any violation of the law of the United6-14
States or of any state, territory or district relating to a controlled substance,6-15
for a category D felony as provided in NRS 193.130, and may be further6-16
punished by a fine of not more than $20,000.6-17
(c) For the first offense, if the controlled substance is listed in schedule6-18
V, for a category E felony as provided in NRS 193.130.6-19
(d) For a second or subsequent offense, if the controlled substance is6-20
listed in schedule V, for a category D felony as provided in NRS 193.130.6-21
3. Unless a greater penalty is provided in NRS 212.160, 453.337 or6-22
453.3385, a person who is convicted of the possession of flunitrazepam or6-23
gamma-hydroxybutyrate, or any substance for which flunitrazepam or6-24
gamma-hydroxybutyrate is an immediate precursor, is guilty of a category6-25
B felony and shall be punished by imprisonment in the state prison for a6-26
minimum term of not less than 1 year and a maximum term of not more6-27
than 6 years.6-28
4. Unless a greater penalty is provided in NRS 212.160, a person who6-29
is6-30
less than 1 ounce of marihuana:6-31
(a) For the first and second offense, is guilty of a category E felony and6-32
shall be punished as provided in NRS 193.130.6-33
(b) For a third or subsequent offense, is guilty of a category D felony6-34
and shall be punished as provided in NRS 193.130, and may be further6-35
punished by a fine of not more than $20,000.6-36
5. Before sentencing under the provisions of subsection 4 for a first6-37
offense, the court shall require the parole and probation officer to submit a6-38
presentencing report on the person convicted in accordance with the6-39
provisions of NRS 176A.200. After the report is received but before6-40
sentence is pronounced the court shall:6-41
(a) Interview the person convicted and make a determination as to the6-42
possibility of his rehabilitation; and7-1
(b) Conduct a hearing at which evidence may be presented as to the7-2
possibility of rehabilitation and any other relevant information.7-3
6. As used in this section, "controlled substance" includes7-4
flunitrazepam, gamma-hydroxybutyrate and each substance for which7-5
flunitrazepam or gamma-hydroxybutyrate is an immediate precursor.~