In updating regulations, the Board should recognize the costs and regulatory burdens on optometry as a small business.  Unless required in statute or unique to optometry, the Board should not impose regulatory provisions on optometry if the Board of Medicine (BOM) does not have the same or similar regulations applicable to ophthalmology.

Recognized medical terms used by the profession don’t need definition.  Doing so will cause confusion.  BOM does not define such terms for ophthalmology.

Changing location of sections in regulations should only be done if exact, current language is changed.  Otherwise, word changes can unintentionally change meaning.

We urge no changes in language or location of regulations regarding commercial or corporate practice.  Changes may unintentionally weaken the prohibitions which prevent corporate for profit interests from interfering with an optometrist’s professional judgment and thus protect the public from substandard care. 

18VAC105-20-05 E should include at least 50% of the hours be face to face (as is current law for renewal).

18VAC105-15 D should remain. 

18-VAC-105-20-16 A2:  suggest having the Board set passing score rather than rely on testing agency.

18VAC105-20-45 Standards of Practice:  Like the BOM, Board of Optometry should not duplicate state or federal laws in regulations.  There is no need to include in regulations such as that in HB 1497 (2017 session) or FTC rules.  Ophthalmology does not have such in the BOM regulations.  Both the Optometry Board and BOM have the authority to discipline licensees violating statute.  Federal rules should be enforced by the feds!

18VVAC105-20-45 B5 should simply state the date of the exam.  Whether or not there is an expiration date is a matter of professional judgment.  Again, BOM has no such regulations for ophthalmology as now in place for ODs.  We oppose any provision to require a prescription including an expiration date to document its necessity.  Such is NOT included in HB 1497 and is NOT currently part of any FTC Rule.

18VAC105-20-47 A1:   Limitation on prescriptions for hydrocodone-combination agents should reflect either that applicable for ophthalmology or not at all.    We would strongly oppose any suggestion of a required referral to an ophthalmologist.  For the conditions which are treated with these agents, optometrists are more trained and experienced in treating such.  

18VAC105-20-50 B should reflect the updated statutory restrictions on Schedule II.  Also, section should be updated to exclude on Schedule I and II (latter limited to hydrocodone combo).  Note, current regs are inaccurate in that TPA certified may prescribe III, IV, V, and VI.  (Regs currently exclude V).

18VAC105-20-60 A.  We support a December 31 license expiration date.  It’s easy to remember and coincides with CE conferences prior to that date.

18VAC105-20-60 D.    We support adding a provision of 40 hours CE if no active practice.  BUT, any CE should be face to face (otherwise, its 4 days of 10 hrs video).  Those not in active practice need to meet higher standard to ensure current standard of practice and knowledge.

18VAC105-20-70 H:  The Board does have jurisdiction over CE sponsors.  By regulation, they can remove a sponsor from the approved list.

18VAC105-20-70 H1:  in addition to CE records identifying course delivery, also require if course is applicable for the accepted “business hours.”

The above comments are in response to Board staff suggestions presented to the Board.  Opportunity to provide advance comments are appreciated.  Essentially, we support proceeding with updating these regulations, and encourage this process to reduce unncessary regulations, remove those addressed in Virginia Code or federal laws or rules, and consider whether it reflects unfair and discriminatory practices against  Virginia optometrists by imposing regulations on that profession which are not in the Va Board of Medicine regulations for ophthlamologists.

--  Comments on behalf of the Virginia Optometric Association