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“(b) This Act shall not be deemed to require a physician or surgeon licensed under the laws of the District of Columbia for the practice of medicine or surgery to have a license under this Act to perform those services defined by this Act as the practice of optometry.

'(c) This Act, other than section 8, shall not apply to any person who fills the written prescription of a physician, surgeon, or an optometrist, and who does not otherwise practice optometry, but this subsection shall not be deemed to authorize such a person to fit contact lenses. “(d) Nothing in this Act shall be deemed to prevent

“(1) an optometric clinic approved by the Commissioners from being conducted on a nonprofit basis by a school or college of optometry or by an association of optometrists;

“(2) an optometrist from being employed by or associated with any hospital, clinic, group health practice, nonprofit health service, health expense indemnity corporation or group, or any department, agency, or instrumentality of the Government of the United States or of the government of the District of Columbia, or as an employee of any person to render optometric service and care solely to employees of such person;

“(3) the widow or widower of a deceased optometrist from continuing for a period not to exceed one year after the death of such deceased optometrist, the practice of such deceased optometrist through the services of another optometrist;

“(4) the wife or husband of an optometrist who, in the opinion of the Commissioners, is temporarily mentally incapacitated, from continuing the practice of such optometrist through the services of another optometrist;

(5) the wife or husband of an optometrist who, in the opinion of the Commissioners, is permanently mentally incapacitated, from continuing for a period not to exceed one year from the date the Commissioners determine such incapacity, the practice of such optometrist through the services

of another optometrist. "(e) Nothing in this Act shall be deemed to prohibit an optometrist from using the title 'doctor' or any abbreviation thereof except that if he uses such title or such an abbreviation it must be with such qualifications as may be necessary to clearly indicate to the public that he is an optometrist.

“Sec. 10. (a) The Commissioners from time to time shall prescribe and adopt such rules and regulations as may be necessary to carry out this Act and govern the practice of optometry and the sale of ophthalmic materials which shall include but not be limited to rules and regulations governing the number, size, location, and illumination of signs offering the services of (1) an individual as an optometrist and (2) ophthalmic materials for sale. With respect to the offering of services of an individual as an optometrist, such regulations shall limit the offering thereof to the carrying or publishing of a modest professional card and the display of a modest window or street sign at the location of the individual's practice, which professional card or window or street sign shall display only the name, address, profession, office hours, telephone connections, and if the practice is so limited the specialty practiced by the individual, and in the case of change of address or the starting of practice, to modest announcements thereof. With respect to the offering for sale of ophthalmic materials, such regulations shall limit the offering for sale thereof to a modest window or street sign at the location of the person's place of business and other modest advertisements. Nothing in this section shall be deemed to authorize any optometric service or ophthalmic materials to be advertised in any manner which includes or contains any price, cost, or reference thereof.

"(b) (1) The Commissioners are authorized and empowered, after public hearing, to establish, abolish, increase, or decrease, from time to time, such fees and charges as are necessary to defray the approximate cost of administering the provisions of this Act.

(2) All funds derived from fees and charges collected in connection with the administration of this Act shall be paid into the Treasury of the United States to the credit of the District of Columbia.

"(c) The Commissioners shall design and adopt a seal to be used for authenticating records and papers pertaining to the licensing and regulation of optometrists in the District of Columbia. Copies of all records and papers duly certified and authenticated by such seal shall be received in evidence in all courts of the District of Columbia equally and with like effect as the original. Records kept by the Commissioners pertaining to the licensing and regulation of optometrists in the District of Columbia shall be open to public inspection under reasonable rules and regulations prescribed by the Commissioners.

"Sec. 11. The Commissioners may make such inspections, studies, and investigations, and obtain or require the furnishing of such information under oath or affirmation or otherwise, as they deem necessary or proper to assist them in prescribing any regulation or order under this Act, or in the administration or enforcement of this Act and any regulations or rules or orders thereunder. For such purposes, the Commissioners may administer oaths and affirmations, may require by subpena or otherwise the attendance and testimony of witnesses, and the production of documents at any designated place within the District of Columbia. In the event of contumacy or refusal to obey any such subpena or requirement under this section, the Commissioners may make application to the District of Columbia Court of General Sessions for an order requiring obedience thereto. Thereupon, the Court, with or without notice and hearing, as it, in its discretion, may decide, shall make such order as is proper and may punish as a contempt, any failure to comply with such order in accordance with section 11-982 of the District of Columbia Code.

“Sec. 12. Whenever, in the judgment of the Commissioners, any person has engaged in or is about to engage in any act or practice which constitutes or will constitute a violation of any provision of this Act, the Commissioners may make application to the District of Columbia Court of General Sessions for an order either temporarily or permanently enjoining such act or practice, and upon showing by the Commissioners that such person has engaged in or is about to engage in any such act or practice, an injunction, restraining order, or such other order as may be appropriate shall be granted by the court, without bond.

Sec. 13. (a) Prosecutions for violations of any of the provisions of this Act shall be conducted in the name of the District of Columbia in the District of Columbia Court of General Sessions by the Corporation Counsel or any of his assistants.

“(b) It shall be necessary to prove in any prosecution or hearing authorized by this Act, only a single act prohibited by law, without proving a general course of conduct in order to constitute a violation.

"(c) Testimony of an optometrist licensed under this Act relating to the practice of optometry as defined in this Act shall be received at any trial or hearing in the courts of the District of Columbia as qualified expert evidence and testimony in respect to the practice of optometry. Certificates of ocular or visual condition, acuity, and efficiency issued by any duly licensed optometrist under this Act, shall be accepted as qualified evidence of the ocular and visual condition, acuity, and efficiency of the person to whom such certificate shall relate, in any trial or hearing in the courts of the District of Columbia and by any officer or employee of the government of the District of Columbia in the performance of his duties.

"SEC. 14. No officer or employee of the District of Columbia shall, in the administration of any law applicable to the District of Columbia, deprive any person of his freedom of choice of practitioner with respect to his visual problems.

"Sec. 15. The Commissioners are authorized to delegate to the Board of Optometry established by Reorganization Order No. 59 all or any part of the powers, duties, and functions vested in them by this Act. The Commissioners are authorized to delegate to any other officer or employee of the government of the District of Columbia all or any part of such powers, duties, and functions. Any delegation made under authority of this section shall be for such periods and subject to such conditions as the Commissioners determine necessary.'

SEC. 2. Every license to practice optometry in the District of Columbia which is valid on the effective date of this Act shall continue to be valid under the District of Columbia Optometry Act as amended by this Act until such date within one year of the effective date of this Act as the Commissioners of the District of Columbia fix as the date for the automatic annual renewal for such license under the District of Columbia Optometry Act, and any such license which would have expired between the effective date of this Act and the annual renewal date fixed for such license by the Commissioners under this section shall continue in effect until such renewal date, unless sooner suspended or revoked in accordance with the District of Columbia Optometry Act.

SEC. 3. Subsection (a) of section 11-742 of the District of Columbia Code is amended (1) by striking out "and" at the end of paragraph (9); (2) by striking out the period at the end of paragraph (10) and inserting in lieu thereof a semicolon; and (3) by adding at the end thereof the following new paragraph:

“(11) final decisions and orders of the Commissioners of the District of Columbia denying, suspending, or revoking any license, denying any renewal of a license or reinstatement of a license, pursuant to the District of Columbia Optometry Act.”

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Sec. 4. This Act shall take effect on the ninetieth day after the date of its enactment.

Mr. Dowdy. I have a memorandum prepared by the staff, setting forth in brief the main provisions of the bills and what they amend. I will make that a part of the record.

(The staff memorandum, dated March 21, 1966, follows:) RE Bills To REGULATE THE PRACTICE OF OPTOMETRY: H.R. 12937 (Sisk),

H.R. 10249 (FUQUA), H.R. 13155 (SHRIVER), H.R. 13176 (SPRINGER), H.R. 13623 (HUT)

PURPOSE OF BILLS

To amend 1924 District of Columbia optometry law (approved May 28, 1924, 43 Stat. 177, D.C. Code, title 2, secs. 501-522) and set up new and improved standards to conform to those in the 50 States and territories which now require higher qualifications than the District of Columbia.

MAIN PROVISIONS OF BILLS

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(1) Optometry is declared a profession (sec. 2).—The practice of optometry affects the health, welfare and safety of the public thereby requiring regulation.

Present law: Optometry is defined as application of optical principles through technical methods and devices (2–501).

(2) Practice of optometry defined (sec. 3(2)).—Expands and extends present definition to bring it up to date with definitions of other States.

(3) Requirements for licensure (sec. 4).- Requires high school diploma plus 2 years college level courses preparatory to professional study and 4 years professional training at accredited institutions.

Present law: Requires 2-year high school course and graduation from a course in optometry of not less than 1,000 hours (2–511).

(4) Reciprocity with other States (sec. 5). —Provides reciprocity privileges to an individual licensed to practice in another State who passes a practical and oral examination.

Present law: Does not require examination of applicant for reciprocity license (2-518).

(5) Revocation, suspension and refusal to grant licenses (sec. 7).—Prohibits advertising, displays, signs (other than modest announcements) by holder of license, and similar arrangements to solicit or induce patronage. Also prohibits practice as an employee of a person other than a duly licensed optometrist.

Present law: Specifically names the following reasons only for suspension, revocation, cancellation or refusal of a license: crime involving moral turpitude or habitual use of narcotics.

(6) Unlawful for other persons to engage in practice of optometry (sec. 8): – Prohibits the advertising of optometric services or materials which contain price, cost or reference thereto; rebates or kickbacks; other inducements to induce patronage; the payment for the services of an optometrist except by another optometrist; and deceptive practices. Provides penalties for such unlawful acts.

Present law: Is limited to the following: practice of optometry without a license prohibited, misrepresentation, false impersonation, penalties.

(7) Exemptions from the act (sec. 9).-Sets forth a series of exemptions. It provides that a physician or surgeon shall not be required to have a license under the optometry law. Opticians are permitted to fill the written prescription of a physician or an optometrist.

Present law: Physicians, surgeons persons selling spectacles or eyeglasses are not governed by the act.

(8) Power of injunction (sec. 12).—Commissioners have right invoke an injunction to restrain a violation. Present law: No provision for injunction.

(9) Freedom of choice (sec. 14). - Persons with visual problems related to the practice of optometry cannot be denied their right to obtain the services of an optometrist by any agent or employee of the District of Columbia.

Present law: Does not contain any provision relating to the deprivation of a person's freedom to select between the licensed disciplines who provide vision

(10) Current licenses continue to be valid (sec. 15).-Holders of licenses on the effective date of the act continue to be in effect.

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Mr. Dowdy. Mr. Sisk is one of the valued members of this subcommittee. One of the bills is his. Do you have a statement that you would like to make at this time, Mr. Sisk?

Mr. Sisk. Mr. Chairman, I would like to make a very brief oral statement and then have permission to insert a more extensive statement into the record.

Mr. Dowdy. Go right ahead.

STATEMENT OF HON, B. F. SISK, A REPRESENTATIVE IN CONGRESS

FROM THE STATE OF CALIFORNIA

Mr. Sisk. Mr. Chairman, the bill which I introduced, H.R. 12937, and which I might say I understand is wholly similar or identical to the majority of the other bills, was introduced because of what seemed to me to be a rather grave need to update legislation pertaining to the regulations and licensing of optometry in the District of Columbia. As we know, the original regulatory legislation was passed in 1924, and my own experience with the practice

and the profession of optometry in my home State of California, and I know this generally to be true in other States. The law has been updated over the years. Certainly when we examine what has been happening here in the District of Columbia it is apparent that the need to update the law here is long overdue.

Let me say, Mr. Chairman, that my prime interest in this legislation is to see to it that the public is protected from unethical practices which would lead to the detriment of people.

We have had local experiences here, even in recent months, of practices which certainly I am sure are foreign to anyone in the medical profession or anyone else who is concerned about the care and are concerned for the eyesight of the American people. It is, as I say, for that purpose that I introduced the legislation.

I might just say, Mr. Chairman, that there have been, I noticed within recent days, quite a few charges as to the possible effect of this particular piece of legislation. I personally want to say that there is no intent here to do anything other than what is done in the majority of the States of our Union with reference to the profession and the practice of optometry. There is certainly no intention here to include the sale of sunglasses or eyeshades by normal outlets such as we find across the country. There is certainly no intent here to change the requirements as far as drivers' tests and many other tests that are made, because from my own experience in my home State, where we do have legislation in existence regarding the practice of optometry very similar to what is proposed in this legislation, we have no such problems. I am sure that as these hearings proceed, Mr. Chairman, these things will be made clear.

I recognize, of course, that, upon the introduction of any piece of legislation, it is not necessarily always perfect in its initial form. A great deal of work has been done in attempting to perfect this legislation, but at the same time I am sure that the committee in its widsom may find changes that will be necessary, because if there is any concern about the intent, I am sure that will be very clearly spelled out.

Now, simply to conclude my comments, my opening comments, Mr. Chairman, I was somewhat amazed to find some of our friends in the medical profession apparently somewhat concerned. This recalls to my mind a situation that has been going on for the past couple of years, where the ophthalmologists, for whom I have great respect, have been quite concerned about an attack upon their dispensing of glasses, by the Guild of Opticians. I am sure that they recall the occurrences of the Hart hearings in the other body, and the Senate bill which has been introduced. I met with the ophthalmologists. I find myself frankly very favorably impressed by their position with reference to that legislation. So I was a little bit amused, Mr. Chairman, to find them getting in bed with the opticians and in opposition to this bill. But I suppose here again it is a matter of whose ox is being gored.

But I am sure that the medical profession is as concerned as the rest of us with reference to eye care. All we seek to achieve is improved eye care and care of the public and the treatment of the public in this particular legislation. Mr. Chairman, I appreciate the opportunity to make this brief statement. (A prepared statement submitted by Mr. Sisk follows:)

LEGISLATION FOR EYE CARE IN THE DISTRICT OF COLUMBIA The bill which I have introduced (H.R. 12937) amends the act which regulates the practice of optometry in the District of Columbia.

Present law was approved by the Congress on May 28, 1924 (43 Stat. 177, D.C. Code, title 2, secs 501-522). It has not been amended during the more than 40 years which have intervened. Prior to its enactment, all of the 48 States which then constituted our Union, had enacted laws to regulate the practice of optometry. Every one of those laws has since 1924 been amended; most of them several times.

The Washington Daily News, during the past few days, has reported that men who are not required to meet any educational or technical standards are now fitting customers with contact lenses. These men are not licensed, regulated, or supervised in any manner. The News reports that some of the work they are doing is both inadequate and unsanitary. In at least one case, a woman lost the sight of an eye.

Two men have been arrested and charged with violating the District's 42-yearold optometry law. According to the News, one of their reporters who sought to secure contact lenses did not have a doctor's prescription and was not even sent to a doctor to secure one. The salesman attempted to figure out the prescription from the glasses the reporter was wearing. This is highly dangerous, as not everyone can be fitted with contact lenses and those that can wear them generally need a different prescription from the one given them for their spectacles. The contact lenses may cause an abrasion of the eyeball, which, if infected, may result in the total loss of the eye.

Even if the accused are convicted, the existing law does not adequately protect the public from those operators who, according to the News report, are at best bilking the public out of its money, and at the worst, damaging their customers' eyesight. The News reports that frequently the unsuspecting public believes it is being served by licensed and well regulated vision specialists.

High-powered advertisements and fancy but expensive installment plans that conceal high rates of interest are being used to sell a health device which, when properly prescribed and fitted, can be highly beneficial to the user; but, on the other hand, it may and often is highly dangerous.

President Johnson well aware of the importance of vision. Pursuant to a joint resolution of the Congress, approved December 30, 1963, the President, on January 28 of this year, issued his Save Your Vision Week proclamation. He began it with a quotation from Shakespeare:

"He that is stricken blind cannot forget the precious treasure of his eyesight lost.'

He went on to say:

“Those words of Shapespeare are relevant to us today as we proclaim Save Your Vision Week, 1966. They remind us that the gift of sight is one of the glories of life. To the child it is a red balloon—a mother's smile--a form in a passing cloud-a tree with autumn leaves.

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