OPTOMETRY

MONDAY, MARCH 21, 1966

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE No. 4 OF THE

COMMITTEE ON THE DISTRICT OF COLUMBIA,

Washington, D.C.

The subcommittee met, pursuant to notice, at 10:10 a.m., in room 1310, Longworth House Office Building, Hon. John Dowdy presiding. Present: Representatives Dowdy, Whitener, Sisk, Grider, Harsha, Horton, and Broyhill.

Also present: James T. Clark, clerk; Hayden S. Garber, counsel; Clayton Gasque, staff director; Donald Tubridy, minority clerk; and Leonard O. Hilder, investigator.

Mr. DowDY. We have hearings set this morning on a group of bills to regulate the practice of optometry in the District of Columbia: H.R. 12937 by Mr. Sisk, H.R. 13049 by Mr. Fuqua, H.R. 13176 by Mr. Springer, H.R. 13155 by Mr. Shriver, H.R. 13623 by Mr. Huot, and H.R. 13821 by Mr. Nelson. They will be made part of the record.

(H.R. 12937, H.R. 13049, H.R. 13176, H.R. 13155, H.R. 13623, and H.R. 13821 are as follows:)

(H.R. 12937, introduced by Mr. Sisk on February 21, 1966; H.R. 13049, introduced by Mr. Fuqua on February 24, 1966; H.R. 13176, introduced by Mr. Springer on March 1, 1966; H.R. 13155, introduced by Mr. Shriver on March 1, 1966; H.R. 13623, introduced by Mr. Huot on March 15, 1966; and H.R. 13821, subsequently introduced by Mr. Nelson on March 21, 1966, are identical as follows:)

A BILL To amend the Act of May 28, 1924, to revise existing law relating to the examination, licensure registration, and regulation of optometrists and the practice of optometry in the District of Columbia, and for other purposes

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That the Act entitled "An Act to regulate the practice of optometry in the District of Columbia", approved May 28, 1924, as amended (D.C. Code, secs. 501-522), is amended to read as follows:

"SECTION 1. This Act may be cited as the 'District of Columbia Optometry Act'.

"SEC. 2. Optometry is hereby declared to be a profession. The practice of optometry in the District of Columbia is hereby declared to affect the public health, welfare, and safety, thus requiring regulation and control in the public interest. It is further declared to be a matter of public interest and concern that the practice of optometry be limited to qualified persons, admitted to the practice of optometry in the District of Columbia under the provisions of this

Act.

"SEC. 3. As used in this Act

"(1) 'Commissioners' means the Board of Commissioners of the District of Columbia;

"(2) 'practice of optometry' means any one, any combination, or all of the following acts or practices: the employment of any objective or subjective means for the examination of the human eye, including its associated

structures; the measurement of the powers or range of human vision; the determination of the accommodative and refractive powers of the human eye; the determination of the scope of the functions of the human eye in general; the prescription, adaptation, use, or furnishing of lenses, prisms, or frames for the aid thereof; the prescribing, directing the use of, or administering vision training or orthoptics, and the use of any optical device in connection therewith; the prescribing of contact lenses for, or the fitting or adaptation of contact lenses to the human eye; and the identification of any departure from the normal condition or function of the human eye, including its associated structures;

"(3) 'optometrist' means an individual licensed to engage in the practice of optometry in the District of Columbia;

"(4) 'person' means any natural person, corporation, association, company, firm, partnership, or society;

"(5) 'individual' means only a natural person; and

"(6) 'State' means the States of the United States, the Commonwealth of Puerto Rico, and the territories of the United States.

"SEC. 4. The Commissioners shall issue a license to practice optometry in the District of Columbia to any individual who

"(1) is at least twenty-one years of age;

"(2) is of good moral character;

"(3) is mentally competent;

"(4) has satisfied the Commissioners that he has had a preliminary education equivalent to the completion of a four-year course of study in an accredited high school;

"(5) has completed a preoptometric course of at least two years at college level;

"(6) has graduated from a school or college of optometry approved by the Commissioners after completion of a course of study of not less than four

years;

"(7) has passed written, oral, and practical examinations as prescribed by the Commissioners in the following subjects: geometric, physical, and physiological optics; theoretic optometry and optics; anatomy, physiology, and pathology, especially as they relate to the eye and to vision; general practice of optometry; special practice of optometry; practical optometric dispensing and such other subject matters as are taught in the schools and colleges of optometry and which the Commissioners deem necessary to determine the applicant's competence to practice as an optometrist. The Commissioners may accept the results of written examinations given by the National Board of Optometry, but shall conduct their own oral and practical examinations; and

"(8) has paid all the required fees.

"SEC. 5. (a) The Commissioners are authorized to issue reciprocity licenses to an individual who holds a license to practice optometry in another State. An applicant for a reciprocity license may, at the discretion of the Commissioners, be licensed without a written examination but he must be given and successfully pass a practical and oral examination. A reciprocity license shall be granted only

if

"(1) the State in which the applicant's license has been granted accords like privileges to the holder of a license to practice optometry in the District

of Columbia;

"(2) the license of the applicant shall not have been suspended or revoked by any State for any cause which is the basis for suspension or revocation of a license under this Act (other than for nonpayment of fees) unless such license has been reinstated by such State and is in full force and effect at the time of the application for a reciprocity license under this section;

"(3) the applicant for a reciprocity license has not failed to pass an examination for a license under this Act in the District of Columbia after his admission to practice in another State;

"(4) the applicant for a reciprocity license has been engaged in the practice of optometry continuously for not less than five out of the seven years immediately preceding his application for a reciprocity license under this

section.

"(b) If an individual holding a reciprocity license granted under this section fails to actually practice optometry in the District of Columbia within one year after such license has been granted, the Commissioners may revoke such license at any time before such individual actually begins the practice of optometry in the

District of Columbia.

"SEC. 6. Every license issued in accordance with the provisions of this Act shall automatically be renewed annually upon application by the holder of the license and payment of the annual renewal fee. Such annual renewal fee shall be fixed by the Commissioners. If the holder of a license fails to renew his license in accordance with this section, such license shall be suspended and such individual shall not thereafter practice optometry in the District of Columbia until such license shall be reinstated or a new license issued to him under this Act. If such individual thereafter applies for reinstatement of his license, it shall automatically be reinstated upon payment of all intervening renewal and other fees. If such individual fails to have his license reinstated within five years after the date it is suspended under this section, he shall not thereafter be licensed to practice optometry in the District of Columbia until he shall have passed a practical examination given by the Commissioners and paid all intervening renewal and other fees. "SEC. 7. (a) The Commissioners are authorized (A) to refuse to issue, renew, or restore any license authorized by this Act, and (B) to suspend or revoke any license issued under authority of this Act, for any of the following causes

"(1) the use of any title or any other word or abbreviation indicating that the licensee is engaged in the practice of medicine or surgery; "(2) conviction of a crime involving moral turpitude;

"(3) willful violation or repeated violations of any provision of this Act or any of the regulations promulgated by the Commissioners under this Act; "(4) gross incompetence;

"(5) chronic or persistent inebriety, or the habitual use of narcotics;

"(6) affliction with a contagious or infectious disease which, in the opinion of the Commissioners, renders the practice of optometry by the licensee or applicant for a license, dangerous to the public health;

(7) conduct which disqualifies the licensee from practicing optometry with safety to the public;

"(8) advertising directly or indirectly the performance of optometric service or any part thereof, including the furnishing of ophthalmic or optical material, in any form, manner, or way, or through any medium whether it be printed, audible, visible, electronic, or in any other fashion, except as authorized by regulations issued under section 10 of this Act;

"(9) practicing or offering to practice optometry under any name other than that under which he has been duly licensed;

"(10) offering free examinations or other gratuitous services, bonuses, premiums, discounts, credit, or any other inducements for the purpose of obtaining patronage;

"(11) the display of any spectacles, eyeglasses, or spectacle frames or mountings, goggles, sunglasses, lenses, prisms, spectacle or eyeglass cases, ophthalmic material, optometric instruments, diagnostic devices, optical tools, or machinery, or any merchandise, material, or advertising in a manner so as to make it visible from the street or the public corridor of a building; "(12) the display of his license, diplomas, or certificates, in such manner that they may be seen from the outside of the premises where he practices; "(13) except as provided in section 9, the use of the words 'clinic', 'infirmary', 'hospital', 'school', 'college', 'university', or 'institute' in English or any other language in connection with any activity which is essentially the practice of optometry;

"(14) to cause or permit the use of his name, profession, or professional title by or in conjunction with the advertising of his professional services in any form or manner by any person;

"(15) holding himself forth by any means or manner of possessing professional superiority or the ability to perform professional services in a superior manner;

"(16) the employment of or any arrangement, written or oral, with persons who use their efforts or influence to direct patronage to the optometrist; "(17) practice optometry in any retail, mercantile, or commercial store, office, or premises, not exclusively devoted to the practice of optometry or other health care professions;

"(18) except as provided in section 9, the practicing of optometry as an employee of and pursuant to any written or oral arrangement with any person other than a duly-licensed optometrist;

"(19) any other unprofessional conduct.

"(b) The denial, suspension, or revocation of a license issued under this Act shall be made only upon specific charges in writing and after notice and hearing (unless such hearing is waived). A certified copy of any such charge and a notice of hearing, specifying the time and place thereof, shall be served upon the holder

of or applicant for such license to practice as an optometrist in the District of Columbia, at least twenty days before the hearing. The respondent may waive the requirement of hearing contained in this subsection but only in writing. At the hearing, the respondent shall be entitled to counsel and to call witnesses in his defense.

"(c) Upon written application and after hearing, pursuant to notice, the Commissioners may reinstate a license which has been previously revoked, except that no application for reinstatement of a license shall be accepted for consideration prior to the expiration of at least one year following the date on which the applicant's license was revoked.

"SEC. 8. (a) It shall be unlawful for any person

"(1) to engage in the practice of optometry in the District of Columbia without a valid license issued under this Act so to do;

"(2) to practice or offer to practice optometry under the name of any company, association, corporation, trade name or business name, or any other name, except his own proper name as appears on the license issued to him under this Act by the Commissioners;

"(3)(A) to sell or fraudulently obtain or furnish any diploma, license, or record required by this Act or required by the Commissioners under authority of this Act, or aid or abet in the selling, fraudulently obtaining, or furnishing thereof;

"(B) to practice optometry as an optometrist under cover of any diploma, license, or record required by this Act or required by the Commissioners under authority of this Act, illegally or fraudulently obtained or signed or issued unlawfully or under fraudulent representation;

"(C) to use in connection with his name any designation tending to imply that he is an optometrist licensed to practice under this Act if he is not licensed to practice under this Act; or

"(D) to practice optometry as an optometrist during any time his license issued under this Act shall be suspended or revoked.

"(4) to sell or offer to sell eyeglasses, spectacles, frames, mountings, or lenses, or to fit or duplicate lenses, without a written prescription from a physician or optometrist licensed to practice in the District of Columbia;

"(5) to advertise or cause to be advertised any optometric or ophthalmic material of any character which includes or contains any price cost or any reference thereto, whether related to any eye examination or to the cost or price of lenses, glasses, mountings, or ophthalmic articles or devices;

"(6) to offer or cause to be offered free eye examinations or other gratuitous services, bonuses, premiums, discounts, credit, or any other inducements for the purpose of obtaining patronage;

"(7) if he writes a prescription for another, to receive any part of the sum paid or other valuable considerations paid by such person to a third person for filling such prescription; or for such third person to pay to the person writing a prescription any part of the sum paid or other valuable considerations received by such third person for filling of such prescription;

"(8) other than an optometrist to utilize the services of another optometrist on a salary, commission, lease, or any other basis, to engage or undertake to engage, directly or indirectly, in any manner whatsoever, in the practice of optometry;

"(9) to display any sign offering ophthalmic materials for sale in violation of any regulation of the Commissioners issued under authority of section 10 to this Act;

"(10) to practice optometry without conspicuously displaying his license and his current annual renewal registration where he practices.

"(b) A violation of any of the provisions of this section shall constitute a misdemeanor and shall be punished for the first offense by a fine of not more than $500, and upon a second or subsequent conviction thereof, shall be punished by a fine of not less than $500 nor more than $1,000, or by imprisonment in the District jail for not less than three months nor more than one year, or by both such fine and imprisonment.

"SEC. 9. (a) This Act shall not apply

"(1) to any bona fide student of optometry in the clinic rooms of a school of optometry approved by the Commissioners;

"(2) to any commissioned officer in the armed services practicing optometry in the District of Columbia solely in the performance of his military duties; "(3) to an individual licensed in another jurisdiction who is in the District of Columbia to make a clinical demonstration before an optometric society, convention, association of optometrists, or school or college of optometry.

"(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 optome trist 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.