AN ACT making various modifications to the laws of optometry.

The General Assembly of North Carolina enacts:

SECTION 1.  G.S. 90‑118.10 reads as rewritten:

§ 90‑118.10.  Annual renewal of licenses.

Since the laws of North Carolina now in force provided for the annual renewal of any license issued by the North Carolina State Board of Examiners in Optometry, it is hereby declared to be the policy of this State that all licenses licenses, primary and branch, heretofore issued by the North  Carolina State Board of Examiners in Optometry, or hereafter issued by said Board are subject to annual renewal and the exercise of any privilege granted by any license heretofore issued or hereafter issued by the North Carolina State Board of Examiners in Optometry is subject to the issuance on or before the first day of January December 31 of each year of a certificate of renewal of license.

On or before the first day of January December 31 of each year, each optometrist engaged in the practice of optometry in North Carolina shall make application to the North Carolina State Board of Examiners in Optometry and receive from said Board, subject to the further provisions of this section and of this Article, a certificate of renewal of said license.

The application shall show the serial number of the applicant's license, his or her full name, address the address, including the street and the county county, in which he or she has practiced during the preceding year, the date of the original issuance of license to said applicant and such other information as the said Board from time to time may prescribe by regulation.

If the application for such renewal certificate, accompanied by the fee required by this Article, is not received by the Board before January 31 January 1 of each year, an additional fee of fifty dollars ($50.00) shall be charged for renewal certificate. If such application accompanied by the renewal fee is not received by the Board before March 31 January 31 of each year, every person thereafter continuing to practice optometry without having applied for a certificate of renewal shall be guilty of the unauthorized practice of optometry and shall be subject to the penalties prescribed by G.S. 90‑118.11. If the inactive license is not appropriately renewed by December 31 of that year, that license will expire and not be eligible for renewal.

In issuing a certificate of renewal, the Board shall expressly state whether such person, otherwise licensed in the practice of optometry, has been certified to prescribe and use pharmaceutical agents.

SECTION 2.  G.S. 90‑123 reads as rewritten:

§ 90‑123.  Fees.

In order to provide the means of carrying out and enforcing the provisions of this Article and the duties of devolving upon the North Carolina State Board of Examiners in Optometry, the Board is authorized to charge and collect the following fees:

(1)....... Each application for general optometry examinationlicense....... $800.00$1,000

(2)        Each general optometry license renewal, which fee shall

be annually fixed by the Board, and not later than December 15

of each year written notice of the amount of the renewal fee

shall be given to each optometrist licensed to practice in this

State by mailing the notice to the last address of record with

the Board of each such optometrist................................................ 300.00500.00

(2a)..... Each provisional license........................................................................... 300.00

(2b)..... Each renewal of a provisional license...................................................... 100.00

(3)        Each certificate of license to a resident optometrist desiring to

change to another state or territory............................................................ 300.00

(4)        Each license issued to a practitioner of another state or

territory to practice in this State................................................................ 350.00

(5)        Each license to resume practice issued to an optometrist who

has retired from the practice of optometry or who has

removed from and returned to this State................................................... 350.00

(6)        Each application for registration as an optometric assistant

or renewal thereof...................................................................................... 100.00

(7)        Each application for registration as an optometric technician

or renewal thereof...................................................................................... 100.00

(8)....... Each duplicate license or application for a branch office license or renewal thereof for each branch office................................................................................ 100.00.200.00.

SECTION 3.  G.S. 90‑121.2 reads as rewritten:

§ 90‑121.2.  Rules and regulations; discipline, suspension, revocation and regrant of certificate.

(a)        The Board shall have the power to make, adopt, and promulgate such rules and regulations, including rules of ethics, as may be necessary and proper for the regulation of the practice of the profession of optometry and for the performance of its duties. The Board shall have jurisdiction and power to hear and determine all complaints, allegations, charges of malpractice, corrupt or unprofessional conduct, and of the violation of the rules and regulations, including rules of ethics, made against any optometrist licensed to practice in North Carolina. The Board shall also have the power and authority to: (i) refuse to issue a license to practice optometry; (ii) refuse to issue a certificate of renewal of a license to practice optometry; (iii) revoke or suspend a license to practice optometry; and (iv) invoke such other disciplinary measures, censure, or probative terms against a licensee as it deems fit and proper; in any instance or instances in which the Board is satisfied that such applicant or licensee:licensee meets any of the following criteria:

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(7)        Is mentally, emotionally, or physically unfit to practice optometry or is afflicted with such a physical or mental disability as to be deemed dangerous to the health and welfare of his patients. An adjudication of mental incompetency in a court of competent jurisdiction or a determination thereof by other lawful means shall be conclusive proof of unfitness to practice optometry unless or until such person shall have been subsequently lawfully declared to be mentally competent;

(7a)      Is unable to practice optometry with reasonable skill and safety by reason of abuse of alcohol, drugs, chemicals, or any other type of substance, or by reason of any physical or mental illness, abnormality, or other limiting condition;

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(a1)      The Board may, in its discretion, order an applicant or licensee to submit to a mental or physical examination by physicians or physician assistants, or other appropriate licensed health care providers, designated by the Board during the pendency of the licensing application, or before or after charges may be presented against the applicant or licensee. The results of the examination shall be admissible in evidence in a hearing before the Board in accordance with the provisions of this Article. An adjudication of mental incompetency in any court of competent jurisdiction or a determination of mental incompetency by other lawful means shall be conclusive proof of unfitness to practice optometry, unless or until that applicant or licensee is subsequently lawfully declared mentally competent. An adjudication or determination of mental incompetency shall constitute good cause for the issuance of an order by the Board that the licensee immediately cease practice and surrender their license to the Board. Failure to comply with an order under this subsection may be considered unprofessional conduct.

(a2)      In addition to and in conjunction with the actions described above, in subsections (a) and (a1) of this section, the Board may make a finding adverse to a licensee or applicant but withhold imposition of judgment and penalty or it may impose judgment and penalty but suspend enforcement thereof and place the licensee on probation, which probation may be vacated upon noncompliance with such reasonable terms as the Board may impose. The Board may administer a public or private reprimand or a private letter of concern, and the private reprimand and private letter of concern shall not require a hearing in accordance with G.S. 90‑121.3 and shall not be disclosed to any person except the licensee. The Board may require a licensee to: (i) make specific redress or monetary redress; (ii) provide free public or charity service; (iii) complete educational, remedial training, or treatment programs; (iv) pay a fine; and (v) reimburse the Board for disciplinary costs.

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SECTION 4.  G.S. 90‑121.6 reads as rewritten:

§ 90‑121.6.  Reporting and publication of Duty to report judgments, awards, payments, and settlements.

(a)        All optometrists licensed or applying for licensure by the Board shall report to the Board:Board within 30 days of the occurrence of any of the following:

(1)        All medical malpractice judgments or awards affecting or involving the optometrist.

(2)        All settlements in the amount of seventy‑five thousand dollars ($75,000) or more related to an incident of alleged medical malpractice affecting or involving the optometrist where the settlement occurred on or after May 1, 2008.

(3)        All settlements in the aggregate amount of seventy‑five thousand dollars ($75,000) or more related to any one incident of alleged medical malpractice affecting or involving the optometrist not already reported pursuant to subdivision (2) of this subsection where, instead of a single payment of seventy‑five thousand dollars ($75,000) or more occurring on or after May 1, 2008, there is a series of payments made to the same claimant which, in the aggregate, equal or exceed seventy‑five thousand dollars ($75,000).

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(d1)     Reports under this section shall be made to the Board by one of the following methods:

(1)        Certified mail and obtaining a delivery receipt.

(2)        A designated delivery service authorized by G.S. 1A‑1, Rule 4(j) and obtaining a delivery receipt.

(3)        Emailing the Board at their public email address found on the Board's website and confirming receipt by the Board via return email.

(d2)     Failure to report under this section shall constitute unprofessional conduct and shall be grounds for discipline under G.S. 90‑121.2.

(e)        Nothing in this section shall limit the Board from collecting information needed to administer this Article.

SECTION 5.  Article 6 of Chapter 90 of the General Statutes is amended by adding a new section to read:

§ 90‑121.7.  Duty to report certain other acts or events.

(a)        Every licensee has a duty to report to the Board any incidents that the licensee reasonably believes to have occurred involving any of the following, within 30 days of learning about the incident:

(1)        Sexual misconduct of any person licensed by the Board under this Article with a patient. Patient consent or initiation of acts or contact by a patient shall not constitute affirmative defenses to sexual misconduct. For purposes of this subdivision, the term sexual misconduct means vaginal intercourse or any sexual act or sexual contact or touching as described in G.S. 14‑17.20. Sexual misconduct shall not include any act or contact that is for an accepted medical purpose.

(2)        Fraudulent prescribing, drug diversion, or theft of any controlled substances by another person licensed by the Board under this Article. For purposes of this subdivision, the term drug diversion means transferring controlled substances or prescriptions for controlled substances to any of the following:

a.         The licensee for personal use.

b.         The licensee's immediate family member, including a spouse, parent, child, sibling, and any stepfamily member or in‑law coextensive with the preceding identified relatives.

c.         Any other person living in the same residence as the licensee.

d.         Any person with whom the licensee is having a sexual relationship.

e.         Any individual unless for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice.

(b)        For persons issued a license to practice by the Board under this Article, failure to report under this section shall constitute unprofessional conduct and shall be grounds for discipline under G.S. 90‑121.2.

(c)        Any person who reports under this section in good faith and without fraud or malice shall be immune from civil liability. Reports made in bad faith, fraudulently, or maliciously shall constitute unprofessional conduct and shall be grounds for discipline under G.S. 90‑121.2.

(d)       Reports under this section shall be made to the Board by one of the following methods:

(1)        Certified mail and obtaining a delivery receipt.

(2)        A designated delivery service authorized by G.S. 1A‑1, Rule 4(j) and obtaining a delivery receipt.

(3)        Emailing the Board at their public email address found on the Board's website and confirming receipt by the Board via return email.

SECTION 6.  G.S. 90‑127.3 reads as rewritten:

§ 90‑127.3.  Copy of prescription furnished on request.

All persons licensed or registered under this Chapter shall upon request give each patient having received an eye examination a copy of his spectacle prescription. prescription, consistent with Federal Trade Commission rules and guidelines. No person, firm or corporation licensed or registered under Article 17 of this Chapter shall fill a prescription or dispense lenses, other than spectacle lenses, unless the prescription specifically states on its face that the prescriber intends it to be for contact lenses and includes the type and specifications of the contact lenses being prescribed. The prescriber shall state the expiration date on the face of every prescription, and the expiration date shall be no earlier than 365 days after the examination date.

Any person, firm or corporation that dispenses contact lenses on the prescription of a practitioner licensed under Articles 1 or 6 of this Chapter shall, at the time of delivery of the lenses, inform the  recipient both orally and in writing that he return to the prescriber for insertion of the lens, instruction on lens insertion and care, and to ascertain the accuracy and suitability of the prescribed lens. The  statement shall also state that if the recipient does not return to the prescriber after delivery of the lens for the purposes stated above, the prescriber shall not be responsible for any damages or injury resulting from the prescribed lens, except that this sentence does not apply if the dispenser and the prescriber are the same person.

Prescriptions filled pursuant to this section shall be kept on file by the prescriber and the person filling the prescription for at least 24 months after the prescription is filled.

SECTION 7.  Article 6 of Chapter 90 of the General Statutes is amended by adding a new section to read:

§ 90‑127.4.  Dispensing optometrists.

(a)        An optometrist may register under this section and with the North Carolina Board of Pharmacy to dispense certain drugs. A registered dispensing optometrist shall not compound medications or dispense controlled substances. A registered dispensing optometrist shall only dispense legend or prescription drugs to their own patients.

(b)        In order to dispense certain drugs consistent with this section, the dispensing optometrist shall pay the dispensing fee to the North Carolina Board of Pharmacy as set forth in G.S. 90‑85.24 and comply with the dispensing registration process as set forth in G.S. 90‑85.26B. The optometrist shall register with both the North Carolina Board of Pharmacy and the Board and comply with all rules governing dispensing of drugs in accordance with this section.

(c)        Drugs dispensed under this section shall only be for the diagnosis and treatment of abnormal conditions of the eye and its adnexa.

SECTION 8.(a)  Article 4A of Chapter 90 of the General Statutes is amended by adding a new section to read:

§ 90‑85.26B.  Registration of dispensing optometrists.

Each dispensing optometrist who dispenses prescription drugs, for a fee or other charge, shall annually register with the Board on the form provided by the Board and with the licensing board having jurisdiction over the dispensing optometrist. Such dispensing shall comply in all respects with the relevant laws and regulations that apply to pharmacists governing the distribution of drugs, including packaging, labeling, and record keeping. Authority and responsibility for disciplining dispensing optometrists who fail to comply with the provisions of this section are vested in the licensing board having jurisdiction over the dispensing optometrist.

SECTION 8.(b)  G.S. 90‑85.24 reads as rewritten:

§ 90‑85.24.  Fees collectible by Board.

(a)        The Board of Pharmacy shall be entitled to charge and collect not more than the following fees:

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(9)        For annual registration as a dispensing physician under G.S. 90‑85.21(b), seventy‑five dollars ($75.00);

(10)      For reinstatement of registration as a dispensing physician, seventy‑five dollars ($75.00);

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(19)      For reinstatement of a registration to dispense devices, deliver medical equipment, or both, two hundred dollars ($200.00).($200.00);

(20)      For annual registration as a dispensing optometrist under G.S. 90‑127.4, seventy‑five dollars ($75.00);

(21)      For reinstatement of registration as a dispensing optometrist under G.S. 90‑127.4, seventy‑five dollars ($75.00).

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SECTION 9.  The North Carolina State Board of Examiners in Optometry may adopt temporary rules to implement the provisions of this act. The North Carolina Board of Pharmacy may adopt temporary rules to implement Section 8 of this act.

SECTION 10.  This act becomes effective October 1, 2023.