DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
DIRECTOR'S OFFICE
OPTOMETRY - GENERAL RULES
Filed with the secretary of state on
These rules become effective immediately after filing with the secretary of state unless adopted under section 33, 44, or 45a(9) of the administrative procedures act of 1969, 1969 PA 306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these sections become effective 7 days after filing with the secretary of state.
(By authority conferred on the director of the department of licensing and regulatory affairs by sections 16145, 16148, 16174, 16287, and 17431 of the public health code, 1978 PA 368, MCL 333.16145, 333.16148, 333.16174, 333.16287, and 333.17431 and Executive Reorganization Order Nos. 1991-9, 1996-2, 2003-1, and 2011-4, MCL 338.3501, 445.2001, 445.2011, and 445.2030)
R 338.301, R 338.303, R 338.306, and R 338.321 of the Michigan Administrative Code are amended, R 338.302, R 338.305, R 338.307, R 338.309, R 338.311, R 338.313, R 338.315, R 338.317, R 338.319, and R 338.320 are rescinded, and R 338.322, R 338.323, R 338.325, R338.327, R 338.328, R 338.329, R 338.330, R 338.331, R 338.332, and R 338.333 are added, as follows:
PART 1. GENERAL PROVISIONS
R 338.301 Definitions.
Rule 1. (1) As used in these rules:
(a) “AAO” means the American Academy of Optometry.
(b) “ACOE” means the Accreditation Council on Optometric Education.
(a)(c) “Adverse drug reaction" means
an adverse physical or psychological reaction that is experienced by a
person an individual resulting from a diagnostic therapeutic agents
agent administered by an optometrist and that occurs within 24
hours after the drug therapeutic agent was is
administered. An adverse drug reaction may be indicated by symptoms that
include includes any of the following:
(i) Red eye.
(ii) Painful eye.
(iii) Decrease in vision.
(iv) Pale or red swelling of the periocular or periorbital tissues.
(v) Nausea.
(vi) Vomiting.
(vii) Fainting.
(viii) Mental confusion.
(ix) Cessation of respiration.
(b)(d) “AOA” means the American Optometric
Association.
(e) "Board" means the Michigan board of optometry.
(c)(f) "Classroom hour," for the
purpose of determining whether a course of study meets the requirements of
section 17412(2)(a) or 17435(2)(b) of the code, MCL 333.17412(2)(a) or
MCL and 333.17435(2)(b), means a 50 to 60 minute period of
lecture, group discussion, or laboratory directly associated with a course in
pharmacology. Time spent working in a clinic other than as part of a laboratory
directly associated with a course in pharmacology does not qualify as a
“classroom hour.”
(d)(g) “Code" means the public health
code, 1978 PA 368, MCL 333.1101 to 333.25211.
(e)(h) “COPE” means the Council on Optometric
Practitioner Education.
(i) "Course of study in general and clinical
pharmacology" means a course of study that is completed in a board-approved
school or college, in general and clinical pharmacology as it relates to optometry,
with the characteristics described in section 17412(2)(a) of the code, MCL
333.17412(2)(a). Not less than 30 of the 60 classroom hours of the course
of study must be allocated to ocular pharmacology and must emphasize the
systemic effects of, and reactions to, topical ocular diagnostic pharmaceutical
agents, including the emergency management and referral of any adverse
reactions that may occur.
(f)(j) "Course of study relating to
the didactic and clinical use of therapeutic pharmaceutical agents" means
a course of study that is comprised of a minimum of 10 quarter hours or 7 semester
hours of credit or 100 classroom hours of study, is completed in a board-approved
school or college, and is in subjects relating to the didactic and
clinical use of therapeutic pharmaceutical agents related to optometry.
(k) “CPDO” means the Continued Professional Development in Optometry.
(l) “CPR” means cardiopulmonary resuscitation.
(g)(m) "Department" means the Michigan
department of licensing and regulatory affairs.
(i) "Examination and
evaluation,” means that term as defined in section 5553 of the code, MCL
333.5553.
(j)(o) “Informed consent for an established
patient” means consent by a patient or his or her a patient’s legal
representative for treatment, medication, or services after there has been full
disclosure of the facts needed for a the patient or his or her
the patient’s legal representative to make a voluntary decision based on
the elements of knowledge, comprehension, and willingness to receive the
treatment, medication, or service.
(k)(p) “Informed consent for a new patient”
means a written agreement or documentation of a verbal agreement by a patient or
his or her a patient’s legal representative for treatment, medication,
or services after there has been full disclosure of the facts needed for a
the patient or his or her the patient’s legal representative
to make a voluntary decision based on the elements of knowledge, comprehension,
and willingness to receive the treatment, medication, or service.
(q) “MOA” means the Michigan Optometric Association.
(r) “NBEO” means the National Board of Examiners in Optometry.
(l)(s) “New patient” means a patient who has
not received a professional service from a provider in the optometrist’s
practice group within the preceding 3 years and 1 day of the last professional
service received.
(m) “Telehealth,” means that term as defined in
section 16283 of the code, MCL 333.16283.
(t) “TMOD” means Treatment and Management of Ocular Disease.
(2) A term defined in the code has the same meaning when used in these rules.
R 338.302 Opioid
and other controlled substances awareness training for prescribers and dispensers
of controlled substances. Rescinded.
Rule 2. An individual who applies for a controlled
substance license or who is licensed to prescribe or dispense controlled
substances shall complete training in opioid and controlled substances
awareness as prescribed in R 338.3135.
R 338.303 Training standards for identifying victims of human trafficking; requirements.
Rule 3. (1) Pursuant to section 16148 of the code, MCL
333.16148, an individual who is licensed or seeking licensure shall complete
have completed training in identifying victims of human trafficking that
meets the following standards:
(a) Training content that covers all of the following:
(i) Understanding the types and venues of human trafficking in this state or the United States.
(ii) Identifying victims of human trafficking in health
care healthcare settings.
(iii) Identifying the warning signs of human trafficking
in health care healthcare settings for adults and minors.
(iv) Identifying resources for reporting the suspected victims of human trafficking.
(b) Acceptable providers or methods of training include any of the following:
(i) Training offered by a nationally recognized or state
recognized state-recognized health-related organization.
(ii) Training offered by, or in conjunction with, a state or federal agency.
(iii) Training obtained in an educational program that has been approved by the board for initial licensure, or by a college or university.
(iv) Reading an article related to the identification of
victims of human trafficking that meets the requirements of subdivision (a) of
this subrule and is published in a peer review peer-reviewed journal,
health care healthcare journal, or professional or scientific
journal.
(c) Acceptable modalities of training may include any of the following:
(i) Teleconference or webinar.
(ii) Online presentation.
(iii) Live presentation.
(iv) Printed or electronic media.
(2) The department may select and audit a sample of individuals and request documentation of proof of completion of training. If audited by the department, an individual shall provide an acceptable proof of completion of training, including either of the following:
(a) Proof of completion certificate issued by the training provider that includes the date, provider name, name of training, and individual’s name.
(b) A self-certification statement by an the individual.
The certification statement shall must include the individual’s
name and either 1 of the following:
(i) For training completed pursuant to subrule (1)(b)(i) to (iii) of this rule, the date, training provider name, and name of training.
(ii) For training completed pursuant to subrule (1)(b)(iv)
of this rule, the title of article, author, publication name of peer review
peer-reviewed journal, health care healthcare journal, or
professional or scientific journal, and the date, volume, and issue of publication,
as applicable.
(3) Pursuant to section 16148 of the code, MCL
333.16148, the requirements specified in subrule (1) of this rule apply for
license renewals beginning with the 2019 renewal cycle and for an initial license
issued on or after December 21, 2021.
R 338.305 Professional optometric degree program; approval
standards. Rescinded.
Rule 5. (1) The board approves and adopts by reference
the standards of the Accreditation Council on Optometric Education (ACOE) set
forth in the publication entitled "Accreditation Manual: Professional
Optometric Degree Programs" revised January 2019, and updated August 2019,
which provide for the accreditation of professional optometric degree programs.
(2) A professional optometric degree program accredited
by the ACOE is considered approved by the board.
(3) Copies of the Accreditation Manual of the ACOE are
available free of charge from the American Optometric Association’s website at
https://www.aoa.org/optometrists/for-educators/accreditation-council-on-optometric-education/accreditation-resources-and-guidance/optometric-degree-programs-. Printed copies also are available for inspection
and distribution at a cost of 10 cents per page from the Bureau of Professional
Licensing, Department of Licensing and Regulatory Affairs, Ottawa Building, 611
W. Ottawa, P.O. Box 30670, Lansing, Michigan 48909.
R 338.306 Telehealth services; requirements.
Rule 6. (1) An optometrist
who provides telehealth services shall obtain informed consent for an
established patient or informed consent for a new patient before providing
a telehealth service pursuant to section 16284 of the code, MCL 333.16284.
(2) An optometrist who provides a telehealth service
shall maintain evidence of the informed consent in the patient record and
shall retain evidence of the informed consent in compliance with section
16213 of the code, MCL 333.16213.
(3) An optometrist who provides a telehealth service shall comply with section 16285 of the code, MCL 333.16285.
(4) An optometrist providing
a telehealth service may prescribe a drug if the optometrist is a prescriber
acting within the scope of his or her the optometrist’s practice
and in compliance with section 16285 the code, MCL 333.16285, if he or she
the optometrist does both of the following:
(a) If medically necessary, refers the patient to a provider that is geographically accessible to the patient.
(b) Makes
himself or herself available to provide follow up follow-up care
services to the patient or to refer the patient to another provider for follow
up follow-up care.
(5) An optometrist
may provide a telehealth service only when he or she the optometrist complies
with all of the following:
(a) Part 174 of the code, MCL 333.17401 to 333.17437.
(b) The
eye care consumer protection law, part 55A of the code, MCL 333.5551 to 333.5571,
including the duty to perform an examination and evaluation, pursuant to
under sections 5551 to 5559 of the code, MCL 333.5551 to 333.5559.
(6) An optometrist
who provides a telehealth service shall exercise the same standard of care
applicable to a traditional, face-to-face health care healthcare service,
including any necessary face-to-face appointments with a patient to assess, reassess,
and update the patient’s medical condition and the effectiveness of treatment
modalities.
PART
2. LICENSES
R 338.307 Licensure
by examination. Rescinded.
Rule 7. (1)
An applicant for a Michigan optometry license by examination shall submit a
completed application on forms provided by the department, together with the
requisite fee. In addition to meeting the requirements under sections 16174 and
17411 of the code, MCL 333.16174 and MCL 333.17411, an applicant shall satisfy
the requirements of this rule.
(2) An
applicant shall have graduated from a professional optometric degree program
approved by the board, pursuant to R 338.305, and hold the doctor of optometry
degree.
(3) An
applicant shall have achieved a passing score on parts I, II, and III of the
National Board of Examiners in Optometry (NBEO) examinations, including a
passing score on the Treatment and Management of Ocular Disease (TMOD)
examination imbedded in part II and is given by the NBEO or its successor
organization.
(4) An applicant
shall have achieved a minimum scaled score of 75 on the examination of state
laws and rules related to the practice of optometry that is developed and
administered by the department, or an entity approved by the department.
R 338.309
Licensure by endorsement. Rescinded.
Rule 9. An applicant for licensure
by endorsement shall hold an active license in good standing in another state or
province of Canada and submit a completed application on a form provided by the
department, together with the requisite fee. In addition to meeting the
requirements of the code and the administrative rules promulgated under the
code, an applicant shall comply with all of the following requirements as noted
by (√):
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R 338.311 Limited licenses. Rescinded.
Rule 11. (1) The board may
issue an educational limited license, pursuant to section 16182(2)(a) of the
code, MCL 333.16182, to an individual who meets the requirements of the code
and the administrative rules promulgated under the code and who has graduated
from a board-approved professional optometric degree program, or who will graduate
from the program not more than 3 months after applying for an educational limited
license, and who is enrolled in a postgraduate course of study or participates in
a residency program that is offered by the United States Department of Veterans
Affairs or a board-approved institution.
(2) The board may issue a clinical
academic limited license, pursuant to section 16182(2)(c) of the code, MCL
333.16182, to an individual who meets the requirements of the code and the
administrative rules promulgated under the code and who is a graduate of a
board-approved professional optometric degree program and who is employed as a faculty
member at a board-approved professional optometric degree program. An optometrist
who is licensed under this subrule may perform procedures upon patients while
employed as a faculty member at a board-approved professional optometric degree
program, if these procedures are performed under the general supervision of a
faculty member who is fully licensed as an optometrist. An individual who is
licensed under this subrule shall not do either of the following:
(a) Hold himself or
herself out to the public as being engaged in the practice of optometry other
than as a faculty member.
(b) Provide optometric
services outside of his or her employment as a faculty member.
(3) An individual who applies
for a limited license under section 16182(2)(a) or (c) of the code, MCL
333.16182(2), shall meet all of the following requirements:
(a) Comply with section
16174 of the code, MCL 333.16174.
(b) Submit proof of
graduation from an accredited professional optometric degree program that is
approved by the board or from a non-accredited professional optometric degree
program that is approved by the board, pursuant to R 338.305.
(c) Submit proof of
appointment to either of the following:
(i) A postgraduate course
of study or a residency program, pursuant to subrule (1) of this rule.
(ii) A faculty position at a
board-approved professional optometric degree program, pursuant to subrule (2)
of this rule.
(4) Limited licenses, pursuant
to subrules (1) and (2) of this rule, may be renewed annually at the discretion
of the board.
(5) Applicants for renewal
of a clinical academic limited license shall submit evidence of having completed
10 hours of board-approved continuing education in pharmacological management of
ocular conditions required for the year.
R 338.313 Relicensure.
Rescinded.
Rule 13. (1) An applicant whose
Michigan license has lapsed may be relicensed under section 16201(3) or (4)
of the code, MCL 333.16201, as applicable, if the applicant meets the requirements
of the code and the administrative rules promulgated under the code and satisfies
the following requirements as noted by (√):
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(2) If
relicensure is granted and it is determined that a sanction has been imposed by
another state, the United States military, the federal government, or another
country, the disciplinary subcommittee may impose appropriate sanctions under
section 16174(5) of the code, MCL 333.16174.
R 338.315 Certification to
administer topical ocular diagnostic pharmaceutical agents; application;
qualifications; adoption of standards; prohibitions. Rescinded.
Rule 15. (1) An applicant for
certification to administer a topical ocular diagnostic pharmaceutical agent in
the practice of optometry shall submit a completed application, on a form
provided by the department, together with the requisite fee. In addition to
meeting the other requirements of the code and the administrative rules promulgated
under the code, an applicant shall satisfy all of the following requirements:
(a) Successfully complete a
course of study in general and clinical pharmacology related to the practice of
optometry as required in section 17412(2)(a) of the code, MCL 333.17412. The
course of study must include passing an examination on general and ocular
pharmacology. The applicant has successfully completed the required course of
study when he or she has been granted the credit hours designated for the
course of study by the teaching institution where the course is offered.
(b) Establish a
board-approved emergency treatment plan, pursuant to section 17412(2)(d) of the
code, MCL 333.17412, for the management and referral of patients who experience
any adverse drug reaction. To be board-approved, the emergency treatment plan
must include all of the following:
(i) Patient
instructions related to an adverse drug reaction.
(ii) A referral procedure for
a patient reporting an adverse drug reaction.
(iii) The names and contact
information of not less than 3 physicians, clinics, or hospitals to whom the patient
reporting an adverse drug reaction may be referred.
(iv) A documentation procedure
for the information to be included in the patient’s medical record regarding
the report of an adverse drug reaction.
(c) Successfully complete
a course in CPR as required by section 17412(2)(c) of the code, MCL 333.17412, approved
by the department of health and human services, and offered or approved by any
of the following:
(i) The Red Cross.
(ii) The American Heart
Association.
(iii) An accredited hospital.
(iv) An organization or
institution comparable to those identified in paragraphs (i) to (iii) of this subdivision.
(2) A licensed optometrist
shall not use diagnostic pharmaceutical agents in the practice of optometry unless
the optometrist has been certified by the board as being qualified to administer
topical ocular diagnostic pharmaceutical agents.
R 338.317 Certification to administer
and prescribe therapeutic pharmaceutical agents; application; qualifications. Rescinded.
Rule 17. (1) An applicant
for certification to administer and prescribe a therapeutic pharmaceutical agent
in the practice of optometry shall submit a completed application, on a form
provided by the department, together with the requisite fee. In addition to meeting
the other requirements of the code and the administrative rules promulgated under
the code, an applicant shall satisfy all of the following requirements:
(a) Meet the certification
requirements to administer diagnostic pharmaceutical agents under R 338.315.
(b) Successfully complete
a course of study relating to the didactic and clinical use of therapeutic
pharmaceutical agents as required in section 17435(2)(b) of the code, MCL
333.17435.
(c) Establish a
board-approved management plan that complies with section 17435(2)(c) of the
code, MCL 333.17435.
(2) A licensed optometrist shall
not administer or prescribe therapeutic pharmaceutical agents in the practice
of optometry unless the optometrist has been certified by the board as being
qualified to administer and prescribe therapeutic pharmaceutical agents.
PART
3. CONTINUING EDUCATION
R 338.319 Adoption of standards and criteria by reference;
board approval by
application. Rescinded.
Rule 19. (1) The board approves and adopts by reference
the standards and criteria of the Council on Optometric Practitioner Education (COPE)
for accreditation of an activity or qualification of a course that are
set forth in the publications entitled “Activity Accreditation Manual,”
revised February 2017, and “Course Qualification Manual,” revised February
2017. A copy of the publications may be obtained at no cost from
the Association of Regulatory Boards of Optometry’s website at http://www.arbo.org.
Printed copies also are available for inspection and distribution at a cost
of 10 cents per page from the Bureau of Professional Licensing, Department
of Licensing and Regulatory Affairs, Ottawa Building, 611 W. Ottawa, P.O. Box
30670, Lansing, Michigan 48909.
(2) A continuing education program related to the practice
of optometry that has been accredited by COPE is considered approved by
the board.
(3) A continuing education program that is not accredited
by COPE or approved as provided in R 338.320 may apply for board approval by
submitting an application to the department. The application must be received not
less than 90 calendar days before the program presentation. The application
must be reviewed by the board’s continuing education subcommittee. After review
and recommendation of the program by the board’s continuing education subcommittee,
approval of the continuing education program may be granted after a vote of the
full board.
(4) Applications for approval of a continuing
education program must include all the following:
(a) The sponsor’s name.
(b) The sponsor’s address.
(c) The program name.
(d) The program date.
(e) The program location.
(f) The program outline, including all of the
following:
(i) An explanation of how the program is designed
to further educate the licensee through acquisition and application of knowledge,
which results in improved patient outcomes.
(ii) The topics and the name of the speaker of each
topic.
(iii) The times of the specific topics and breaks
included in the program.
(g) The résumé of each speaker or instructor for the
program.
(h) A description of the delivery method, or methods
to be used, and the techniques that will be employed to assure active participation.
(i) A brief description of the sponsoring organization.
(j) The name, title, and address of the program director
and a description of his or her qualifications to direct the program.
(k) A description of how participants will be notified
that continuing education credit has been earned.
(l) A description of the physical facilities or
laboratory available to assure a proper learning environment.
(m) A description of how attendance is monitored and
the name of the person monitoring attendance.
(n) The number of hours of course instruction
including all of the following:
(i) The number of hours related to clinical optometry,
which may include any of the following COPE categories:
(A) Contact lenses (CL).
(B) Functional vision/pediatrics (FV).
(C) General optometry (GO).
(D) Low vision/vision impairment & rehabilitation
(LV).
(E) Public health (PB).
(ii) The number of hours related to practice
management, which may include the following COPE categories:
(A) Practice management (PM).
(B) Ethics/jurisprudence (EJ).
(iii) The number of hours related to pharmaceutical
management, which may include any of the following COPE categories:
(A) Glaucoma (GL).
(B) Injection skills (IS).
(C) Laser procedures (LP).
(D) Peri-operative management of ophthalmic surgery
(PO).
(E) Refractive surgery management (RS).
(F) Surgery procedures (SP).
(G) Treatment and management of ocular disease:
anterior segment (AS).
(H) Treatment and management of ocular disease:
posterior segment (PS).
(I) Neuro-optometry (NO).
(J) Oral pharmaceuticals (OP).
(K) Pharmacology (PH).
(L) Principles of diagnosis (PD).
(M) Systemic/ocular disease (SD).
(iv) The number of hours related to pain management,
which may include any of the following COPE categories:
(A) Oral pharmaceuticals (OP).
(B) Pharmacology (PH).
(C) Treatment and management of ocular disease:
anterior segment (AS).
(D) Treatment and management of ocular disease:
posterior segment (PS).
(E) Functional vision/pediatrics (FV).
R 338.320 Approved continuing education; limitations;
documentation. Rescinded.
Rule 20. The board approves all of the following as
continuing education if the subject matter falls within an approved COPE
category as listed in R 338.319(4)(n):
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PART 2. EDUCATIONAL PROGRAMS, EXAMINATIONS,
LICENSES AND CERTIFICATIONS
R 338.321 License renewal; continuing education,
requirements, limitations.
Professional optometric degree program; approval standards.
Rule 21. (1) An applicant for license renewal shall satisfy
the requirements of the Public Health Code General Rules, R 338.7001 to R 338.7005,
and shall accumulate not less than 40 continuing education hours approved by
the board pursuant to R 338.319 or R 338.320 during the 2 years immediately preceding
the date of application for renewal. The board approves and adopts by
reference the standards of ACOE set forth in the publication entitled, "Accreditation
Council on Optometric Education Policy and Procedure Manual,” published June
2022, which provides for the accreditation of professional optometric degree programs.
A copy of the Accreditation Manual of ACOE is available free of charge from the
AOA’s website at https://www.aoa.org/AOA/Documents/Education/ACOE/ACOE_Policy_and_Procedure_Manual_07_2021.pdf.
Printed copies also are available for inspection and distribution at a cost of
10 cents per page from the Bureau of Professional Licensing, Department of
Licensing and Regulatory Affairs, Ottawa Building, 611 West Ottawa, P.O. Box 30670,
Lansing, Michigan 48909.
(2) An applicant for license renewal who holds
certification to administer topical ocular diagnostic pharmaceutical agents or
certification to administer and prescribe therapeutic pharmaceutical agents, or
both, shall do both of the following: A professional optometric degree
program accredited by ACOE is considered approved by the board.
(a) Accumulate not less
than 20 hours of board-approved continuing education in pharmacological management
of ocular conditions. The 20 required hours are part of, and not in addition
to, the 40 hours required in subrule (1) of this rule. A continuing education program
that falls within the COPE categories listed in R 338.319(4)(n)(iii)(A) to (M) meets
the requirements of this subdivision.
(b) Hold a valid CPR certificate
issued by any of the following:
(i) The Red Cross.
(ii) The American Heart
Association.
(iii) An accredited hospital.
(iv) An organization or
institution comparable to those identified in paragraphs (i) to (iii) of this paragraph.
(3) An applicant for license renewal shall accumulate not
less than 2 hours of board approved continuing education in pain and symptom
management related to the practice of optometry. A continuing education program
that falls within the COPE categories listed in R 338.319(4)(n)(iv)(A) to (E) meets
the requirements of this subrule. Continuing education hours in pain and symptom
management, as they relate to the practice of optometry, may include, but are
not limited to, the following:
(a) Ethics and health policy
related to pain.
(b) Pain definitions.
(c) Basic sciences related
to pain, including pharmacology, psychology, sociology, and anthropology.
(d) Clinical sciences
related to pain, including specific pain conditions and pain in special contexts
and settings.
(e) Clinician-patient communications
related to pain.
(f) Management of pain,
including evaluation and treatment; non-pharmacological and pharmacological
management.
(g) Ensuring quality pain
care.
(h) Michigan programs and resources
relevant to pain.
(4) A minimum of 20 of the required
continuing education hours must be completed in a live, synchronous learning
format. The remaining hours may be completed in any other format.
(5) An applicant for license
renewal may earn a maximum of 9 continuing education hours per licensure cycle
in practice management. A continuing education program that falls within the
COPE categories listed in R 338.319(4)(n)(ii)(A) and (B) meets the requirements
of this subrule.
(6) Submission of an application
for renewal constitutes the applicant's certificate of compliance with the requirements
of this rule. An optometrist shall retain documentation of meeting the requirements
of this rule for a period of 4 years from the date of applying for license
renewal. The board may require an applicant or licensee to submit evidence to
demonstrate compliance with this rule. Failure to comply with this rule is a
violation of section 16221(h) of the code, MCL 333.16221.
(7) A request for a waiver
under section 16205 of the code, MCL 333.16205, must be received by the department
before the expiration date of the license.
R 338.322 Examination approval and adoption; limitations; passing score.
Rule 22. (1) The board approves and adopts the NBEO examinations developed, administered, and scored by the NBEO or its successor.
(2) An applicant applying for licensure shall have achieved a passing score on all of the following parts of the NBEO examinations:
(a) Part I.
(b) Part II, including a passing score on the TMOD examination imbedded in Part II.
(c) Part III.
(3) An applicant for licensure is limited to attempting to achieve a passing score on the NBEO examination to no more than 6 attempts. A licensee shall not sponsor an applicant for licensure that is attempting to achieve a passing score on the NBEO examination if the applicant has previously attempted to pass the examination 6 or more times.
(4) The accepted passing score for each part of the NBEO examination for licensure is the passing scores established by the NBEO or its successor.
R 338.323 Initial licensure by examination.
Rule 23. An applicant for initial licensure by examination shall submit a completed application on the form provided by the department, together with the requisite fee. In addition to meeting the requirements of the code and the administrative rules promulgated under the code, an applicant shall satisfy all of the following requirements:
(a) Have graduated from a professional optometric degree program approved by the board under R 338.321, and hold the doctor of optometry degree.
(b) Have achieved a passing score on parts I, II, and III of the NBEO examinations approved under R 338.322, including a passing score on the TMOD examination imbedded in part II.
(c) Have achieved a minimum scaled score of 75 on the optometry jurisprudence examination developed and administered by the department or an entity approved by the department.
R 338. 325 Licensure by endorsement.
Rule 25. An applicant for licensure by endorsement shall hold an active license in good standing in another state or province of Canada and submit a completed application on a form provided by the department, together with the requisite fee. In addition to meeting the requirements of the code and the administrative rules promulgated under the code, an applicant shall comply with all of the following requirements as noted by (√):
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(a) For an applicant who is licensed in another state: |
Licensed for less than 3 years. |
Licensed 3 years or more. |
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(i) |
Establish that the applicant is of good moral character as defined in, and determined under, 1974 PA 381, MCL 338.41 to 338.47. |
√
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√
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(ii) |
Submit fingerprints as required under section 16174(3) of the code, MCL 333.16174. |
√
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√
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(iii) |
Graduate from a school of optometry approved by the board under R 338.321. |
√
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(iv) |
Achieve a passing score on parts I, II, and III of the NBEO examination, including a passing score on the TMOD examination given by NBEO or its successor organization. |
√
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(v) |
Achieve a minimum scaled score of 75 on the optometry jurisprudence examination developed and administered by the department or an entity approved by the department. |
√
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√
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(vi) |
Hold a license in good standing granting therapeutic prescriptive certification at the highest level authorized in the state of the United States where the applicant is currently licensed. |
√
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√
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(vii) |
Hold a valid CPR certificate issued by any of the following: (A) The Red Cross. (B) The American Heart Association. (C) An accredited hospital. (D) An organization or institution comparable to those identified in subparagraphs (A) to (C) of this paragraph. |
√
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√
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(viii) |
Comply with both of the following: (A) Disclose each license, registration, or certification in a health profession or specialty issued by another state, the United States military, the federal government, or another country on the application form. (B) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application. |
√
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√
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(b) For an applicant who is licensed in a province of Canada: |
Licensed less than 10 years. |
Licensed 10 years or more. |
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(i) |
Establish that the applicant is of good moral character as defined in, and determined under, 1974 PA 381, MCL 338.41 to 338.47. |
√
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√
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(ii) |
Submit fingerprints as required under section 16174(3) of the code, MCL 333.16174. |
√ |
√
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(iii) |
Graduate from a school of optometry approved by the board under R 338.321. |
√
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√
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(iv) |
Achieve a passing score on parts I, II, and III of the NBEO examination, including a passing score on the TMOD examination given by NBEO or its successor organization. |
√ |
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(v) |
Achieve a minimum scaled score of 75 on the optometry jurisprudence examination of developed and administered by the department or an entity approved by the department. |
√
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√
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(vi) |
Hold a license in good standing granting therapeutic prescriptive certification at the highest level authorized in the province of Canada where the applicant is currently licensed. |
√
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√
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(vii) |
Hold a valid CPR certificate issued by any of the following: (A) The Red Cross. (B) The American Heart Association. (C) An accredited hospital. (D) An organization or institution comparable to those identified in subparagraphs (A) to (C) of this paragraph. |
√
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√
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(viii) |
Comply with both of the following: (A) Disclose each license, registration, or certification in a health profession or specialty issued by another state, the United States military, the federal government, or another country on the application form. (B) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application. |
√
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√
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R 338.327 Limited licenses.
Rule 27. (1) The board may issue an educational limited license, under section 16182(2)(a) of the code, MCL 333.16182, to an individual that meets the requirements of the code and the administrative rules promulgated under the code and who meets both of the following:
(a) Has graduated from a board-approved professional optometric degree program, or who will graduate from the program not more than 3 months after applying for an educational limited license.
(b) Is enrolled in a postgraduate course of study or participates in a residency program that is offered by the United States Department of Veterans Affairs or an institution approved by the ACOE.
(2) The board may issue a clinical academic limited license, under section 16182(2)(c) of the code, MCL 333.16182, to an individual who meets the requirements of the code and the administrative rules promulgated under the code and who is a graduate of a board-approved professional optometric degree program and who is employed as a faculty member at a board-approved professional optometric degree program. An optometrist who is licensed under this subrule may perform procedures on patients while employed as a faculty member at a board-approved professional optometric degree program, if these procedures are performed under the general supervision of a faculty member who is fully licensed as an optometrist. An individual who is licensed under this subrule shall not do either of the following:
(a) Hold himself or herself out to the public as being engaged in the practice of optometry other than as a faculty member.
(b) Provide optometric services outside of his or her employment as a faculty member.
(3) An individual who applies for a limited license under section 16182(2)(a) or (c) of the code, MCL 333.16182(2), shall meet all of the following requirements:
(a) Comply with section 16174 of the code, MCL 333.16174.
(b) Submit proof of graduation from an accredited professional optometric degree program that is approved by the board under R 338.321.
(c) Submit proof of appointment to either of the following:
(i) A postgraduate course of study or a residency program, under subrule (1) of this rule.
(ii) A faculty position at a board-approved professional optometric degree program, under subrule (2) of this rule.
(4) A limited license may be renewed 1 time. When applying for renewal, the limited licensee shall submit evidence of having completed 10 hours of board-approved continuing education in pharmacological management of ocular conditions.
Rule 28. (1) An applicant whose license has lapsed may be relicensed under section 16201(3) or (4) of the code, MCL 333.16201, as applicable, if the applicant meets the requirements of the code and the administrative rules promulgated under the code and satisfies the following requirements as noted by (√):
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(a) For an applicant who has let his or her Michigan license lapse and is not currently licensed in another state or in Canada: |
Lapsed 3 years or less. |
Lapsed more than 3 years, but less than 6 years. |
Lapsed 6 years or more. |
|
|
(i) |
Submit a completed application on a form provided by the department, together with the required fee. |
√
|
√
|
√
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|
(ii) |
Establish that the applicant is of good moral character as defined in, and determined under, 1974 PA 381, MCL 338.41 to 338.47. |
√
|
√
|
√ |
|
(iii) |
Submit fingerprints as required under section 16174(3) of the code, MCL 333.16174. |
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√
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√ |
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(iv) |
Submit proof of having completed 40 hours of continuing education as required under R 338.331, that was earned within the 2-year period immediately preceding the date of relicensure, subject to both of the following: (A) At least 2 of the 40 hours of continuing education must be in pain and symptom management, as provided under R 338.331(3). (B) If certified to administer therapeutic pharmaceutical agents, at least 20 of the 40 hours of continuing education must be in pharmacological management of ocular conditions, as provided under R 338.331(2), and the applicant shall hold a current CPR certificate. |
√
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√
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√ |
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(v) |
Achieve a minimum scaled score of 75 on the optometry jurisprudence examination developed and administered by the department, or an entity approved by the department. |
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√
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√ |
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(vi) |
Achieve a passing score on parts I, II, and III of the NBEO examination, including a passing score on the CPDO examination given by NBEO or its successor organization. |
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√ |
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(vii) |
An applicant who is or has ever been licensed, registered, or certified in a health profession or specialty by another state, the United States military, the federal government, or another country, shall do both of the following: (A) Disclose each license, registration, or certification on the application form. (B) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application. |
√
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√
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√
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(b) For an applicant who has let his or her Michigan license lapse and is currently licensed in another state or in Canada: |
Lapsed 3 years or less. |
Lapsed more than 3 years, but less than 6 years. |
Lapsed 6 years or more. |
|
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(i) |
Submit a completed application on a form provided by the department, together with the required fee. |
√
|
√
|
√
|
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(ii) |
Establish that the applicant is of good moral character as defined in, and determined under, 1974 PA 381, MCL 338.41 to 338.47. |
√
|
√
|
√ |
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(iii) |
Submit fingerprints as required under section 16174(3) of the code, MCL 333.16174. |
|
√
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√ |
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(iv) |
Submit proof of having completed 40 hours of continuing education as required under R 338.331, that was earned within the 2-year period immediately preceding the date of relicensure, subject to both of the following: (A) At least 2 of the 40 hours of continuing education must be in pain and symptom management, as provided under R 338.331(3). (B) If certified to administer therapeutic pharmaceutical agents, at least 20 of the 40 hours of continuing education must be in pharmacological management of ocular conditions, as provided under R 338.331(2), and the applicant shall hold a current CPR certificate. |
√
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√
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√ |
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(v) |
Achieve a minimum scaled score of 75 on the optometry jurisprudence examination developed and administered by the department, or an entity approved by the department. |
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√
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√ |
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(vi) |
An applicant who is or has ever been licensed, registered, or certified in a health profession or specialty by another state, the United States military, the federal government, or another country, shall do both of the following: (A) Disclose each license, registration, or certification on the application form. (B) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, including verification from the issuing entity showing that disciplinary proceedings are not pending against the applicant and sanctions are not in force at the time of application. |
√
|
√
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√
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(2) If relicensure is granted and it is determined that a sanction has been imposed by another state, the United States military, the federal government, or another country, the disciplinary subcommittee may impose appropriate sanctions under section 16174(5) of the code, MCL 333.16174.
R 338.329 Certification to administer topical ocular diagnostic pharmaceutical
agents; application; qualifications; adoption of standards; prohibitions.
Rule 29. (1) An applicant for certification to administer a topical ocular diagnostic pharmaceutical agent in the practice of optometry shall submit a completed application, on a form provided by the department, together with the requisite fee. In addition to meeting the other requirements of the code and the administrative rules promulgated under the code, an applicant shall satisfy all of the following requirements:
(a) Successfully complete a course of study in general and clinical pharmacology related to the practice of optometry as required in section 17412(2)(a) of the code, MCL 333.17412. The course of study must include passing an examination on general and ocular pharmacology. The applicant has successfully completed the required course of study when the applicant has been granted the credit hours designated for the course of study by the teaching institution where the course is offered.
(b) Establish a board-approved emergency plan, under section 17412(2)(d) of the code, MCL 333.17412, for the management and referral of patients who experience any adverse drug reaction. To be board-approved, the emergency plan must include all of the following:
(i) Patient instructions related to an adverse drug reaction.
(ii) A referral procedure for a patient reporting an adverse drug reaction.
(iii) The names and contact information of not less than 3 physicians, clinics, or hospitals to whom the patient reporting an adverse drug reaction may be referred.
(iv) A documentation procedure for the information to be included in the patient’s medical record regarding the report of an adverse drug reaction.
(c) Successfully complete a course in CPR as required by section 17412(2)(c) of the code, MCL 333.17412, approved by the department of health and human services, and offered or approved by any of the following:
(i) The Red Cross.
(ii) The American Heart Association.
(iii) An accredited hospital.
(iv) An organization or institution comparable to those identified in paragraphs (i) to (iii) of this subdivision.
(2) A licensed optometrist shall not use diagnostic pharmaceutical agents in the practice of optometry unless the optometrist has been certified by the board as being qualified to administer topical ocular diagnostic pharmaceutical agents.
R 338.330 Certification to administer and prescribe therapeutic pharmaceutical
agents; application; qualifications.
Rule 30. (1) An applicant for certification to administer and prescribe a therapeutic pharmaceutical agent in the practice of optometry shall submit a completed application, on a form provided by the department, together with the requisite fee. In addition to meeting the other requirements of the code and the administrative rules promulgated under the code, an applicant shall satisfy all of the following requirements:
(a) Meet the certification requirements to administer diagnostic pharmaceutical agents under R 338.315.
(b) Successfully complete a course of study relating to the didactic and clinical use of therapeutic pharmaceutical agents as required in section 17435(2)(b) of the code, MCL 333.17435.
(c) Establish a board-approved management plan that complies with section 17435(2)(c) of the code, MCL 333.17435.
(2) A licensed optometrist shall not administer or prescribe therapeutic pharmaceutical agents in the practice of optometry unless the optometrist has been certified by the board as being qualified to administer and prescribe therapeutic pharmaceutical agents.
PART 3. CONTINUING EDUCATION AND LICENSE RENEWAL
R 338.331 License renewal; continuing education, requirements, limitations.
Rule 31. (1) An applicant for license renewal shall satisfy the requirements of the R 338.7001 to R 338.7005 and accumulate not less than 40 continuing education hours approved by the board under R 338.332 or R 338.333 during the 2 years immediately preceding the date of application for renewal.
(2) An applicant for license renewal who holds certification to administer topical ocular diagnostic pharmaceutical agents or certification to administer and prescribe therapeutic pharmaceutical agents, or both, shall do both of the following:
(a) Accumulate not less than 20 hours of board-approved continuing education in pharmacological management of ocular conditions. The 20 required hours are part of, and not in addition to, the 40 hours required in subrule (1) of this rule. A continuing education program that falls within COPE categories listed in R 338.332(7)(n)(iii)(A) to (I) meets the requirements of this subdivision.
(b) Hold a valid CPR certificate issued by any of the following:
(i) The Red Cross.
(ii) The American Heart Association.
(iii) An accredited hospital.
(iv) An organization or institution comparable to those identified in paragraphs (i) to (iii) of this paragraph.
(3) An applicant for license renewal shall accumulate not less than 2 hours of board approved continuing education in pain and symptom management related to the practice of optometry. A continuing education program that falls within COPE categories listed in R 338.332(6)(n)(iv)(A) to (C) meets the requirements of this subrule. Continuing education hours in pain and symptom management, as they relate to the practice of optometry, may include, but are not limited to, the following:
(a) Ethics and health policy related to pain.
(b) Pain definitions.
(c) Basic sciences related to pain, including pharmacology, psychology, sociology, and anthropology.
(d) Clinical sciences related to pain, including specific pain conditions and pain in special contexts and settings.
(e) Clinician-patient communications related to pain.
(f) Management of pain, including evaluation and treatment and non-pharmacological and pharmacological management.
(g) Ensuring quality pain care.
(h) Michigan programs and resources relevant to pain.
(4) A minimum of 20 of the required continuing education hours must be completed in a live, synchronous learning format. The remaining hours may be completed in any other format.
(5) An applicant for license renewal may earn a maximum of 9 continuing education hours per licensure cycle in practice management. A continuing education program that falls within COPE categories listed in R 338.332(6)(n)(ii)(A) and (B) meets the requirements of this subrule.
(6) Submission of an application for renewal constitutes the applicant's certificate of compliance with the requirements of this rule.
(7) An optometrist shall retain documentation of meeting the requirements of this rule for a period of 4 years after the date of applying for license renewal. The licensee’s documentation must show the licensee’s name, number of credits earned per program or activity, the sponsor’s name or the name of the organization that approved the program or activity, and the date that the program was held or activity was completed. The board may require an applicant or licensee to submit evidence to demonstrate compliance with this rule. Failure to comply with this rule is a violation of section 16221(h) of the code, MCL 333.16221.
(8) A request for a waiver under section 16205 of the code, MCL 333.16205, must be received by the department at least 30 days before the last regularly scheduled board meeting before the expiration date of the license.
R 338.332 Adoption of standards and criteria by reference; board approval of
continuing education programs.
Rule 32. (1) The board approves and adopts by reference the standards and criteria of COPE for accreditation of an activity or qualification of a course that are set forth in the publications entitled “Activity Accreditation Manual,” revised July 2022, and “Course Qualification Manual,” revised July 2022. A copy of the publications may be obtained at no cost from the Association of Regulatory Boards of Optometry’s website at http://www.arbo.org. Printed copies also are available for inspection and distribution at a cost of 10 cents per page from the Bureau of Professional Licensing, Department of Licensing and Regulatory Affairs, Ottawa Building, 611 West Ottawa, P.O. Box 30670, Lansing, Michigan 48909.
(2) A continuing education program related to the practice of optometry that has been accredited by COPE is considered approved by the board.
(3) A course or continuing education program related to the practice of optometry offered by a college or university program approved by the board under R 338.321 is considered approved by the board.
(4) A continuing education program related to the practice of optometry that has been approved or sponsored by the AAO, the AOA, or the MOA is considered approved by the board.
(5) A continuing education program related to the practice of optometry that has been approved by another state board of optometry is considered approved by the board.
(6) A continuing education program that is not approved by the board under subrules (1) to (5) of this rule, or as provided in R 338.333, may apply for board approval by submitting an application to the department. The application must be received not less than 90 calendar days before the program presentation. An application received less than 90 days before the program presentation will be denied as untimely.
(7) An application for approval of a continuing education program must include all the following:
(a) The sponsor’s name.
(b) The sponsor’s address.
(c) The program name.
(d) The date of the next scheduled program.
(e) The program location.
(f) The program outline, including all of the following:
(i) An explanation of how the program is designed to further educate the licensee through acquisition and application of knowledge, that results in improved patient outcomes.
(ii) The topics and the name of the speaker of each topic.
(iii) The times of the specific topics and breaks included in the program.
(g) The résumé of each speaker or instructor for the program.
(h) A description of the delivery method, or methods to be used, and the techniques that will be employed to ensure active participation.
(i) A brief description of the sponsoring organization.
(j) The name, title, and address of the program director and a description of his or her qualifications to direct the program.
(k) A description of how participants will be notified that continuing education credit has been earned.
(l) A description of the physical facilities or laboratory available to ensure a proper learning environment.
(m) A description of how attendance is monitored and the name of the individual monitoring attendance.
(n) The number of hours of course instruction including all of the following:
(i) The number of hours related to clinical optometry, which may include any of the following COPE categories:
(A) Contact lenses (CL).
(B) Functional vision/pediatrics (FV).
(C) General optometry (GO).
(D) Low vision/vision impairment & rehabilitation (LV).
(E) Public health (PB).
(ii) The number of hours related to practice management, which may include the following COPE categories:
(A) Practice management (PM).
(B) Ethics/jurisprudence (EJ).
(iii) The number of hours related to pharmaceutical management, which may include any of the following COPE categories:
(A) Glaucoma (GL).
(B) Injection skills (IS).
(C) Laser procedures (LP).
(D) Peri-operative management of ophthalmic surgery (PO).
(E) Surgery procedures (Optometric) (SP).
(F) Treatment and management of ocular disease (TD).
(G) Neuro-optometry (NO).
(H) Pharmacology (PH).
(I) Systemic diseases (SD).
(iv) The number of hours related to pain management, which may include any of the following COPE categories:
(A) Pharmacology (PH).
(B) Treatment and management of ocular disease (TD).
(C) Functional vision/pediatrics (FV).
R 338.333 Approved continuing education activities; limitations; documentation.
Rule 33. The board approves all of the following as continuing education if the
subject matter falls within an approved COPE category as listed in R
338.331(7)(n):
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Activity and Proof of Completion |
Number of Continuing Education Hours Granted or Permitted for Activity |
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(a) |
Attendance at a continuing education program related to optometric topics approved for category 1 continuing education by the Michigan board of medicine or the Michigan board of osteopathic medicine and surgery.
If audited, a licensee shall submit a copy of a letter or certificate of completion showing the licensee’s name, number of credits earned, sponsor name or the name of the organization that approved the program or activity for continuing education credit, and the date or dates that the program was held or activity completed. |
One continuing education hour in clinical optometry is earned for each 50 to 60 minutes of program attendance. A maximum of 8 continuing education hours may be earned for this activity in each renewal period. |
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(b) |
Attendance at a continuing education program related to optometric pharmacological topics approved for continuing education by the Michigan board of pharmacy.
If audited, a licensee shall submit a copy of a letter or certificate of completion showing the licensee’s name, number of credits earned, sponsor name or the name of the organization that approved the program or activity for continuing education credit, and the date or dates that the program was held or activity completed. |
One continuing education hour in pharmacological management is earned for each 50 to 60 minutes of program attendance. A maximum of 8 continuing education hours may be earned for this activity in each renewal period. Applicants for renewal who hold certification to administer topical ocular diagnostic pharmaceutical agents or certification to administer and prescribe therapeutic pharmaceutical agents, or both, may earn continuing education hours without limitation. |
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(c) |
Initial presentation of or at a continuing education program approved by the board.
If audited, a licensee shall submit a letter from the program’s sponsor, verifying the licensee’s presentation of educational materials and lecture at the continuing education program. |
One continuing education hour in the appropriate COPE category is earned for each 50 to 60 minutes of program presentation, without limitation.
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(d) |
Initial presentation of a scientific exhibit, poster, or paper to a professional optometric organization.
If audited, the licensee shall submit a copy of the document presented with evidence of presentation or a letter from the program sponsor verifying the date of the presentation. |
Two hours of continuing education in clinical optometry are earned for each presentation. No additional credit is granted for preparation of the presentation. |
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(e) |
Initial publication of either of the following: (i) A scientific article relating to the practice of optometry in a peer-reviewed journal or periodical. (ii) A chapter or a portion of a chapter related to the practice of optometry in either a professional healthcare textbook or peer-reviewed textbook.
If audited, the licensee shall submit a copy of the publication that identifies the licensee as the author or a publication acceptance letter and documentation of the peer-review process. |
Six hours of continuing education in clinical optometry are earned for serving as the primary author. Three hours of continuing education in clinical optometry are earned for serving as a secondary author. |
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(f) |
Participating on either of the following: (i) A peer review committee dealing with quality of patient care as it relates to the practice of optometry. (ii) A national or state committee, board, council, or association related to the practice of optometry.
Participation on a committee, board, council, or association is considered acceptable by the board if it enhances the participant’s knowledge and understanding of the field of optometry.
If audited, the licensee shall submit a letter from an organization official verifying the licensee’s participation in at least 50% of the regularly scheduled meetings of the committee, board, council, or association. |
Six hours of continuing education in clinical optometry are earned for participating on a committee. A maximum of 6 continuing education hours may be earned for this activity in each renewal period. |
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(g) |
Taking and passing any nationally recognized advanced competency examination in optometry. |
Every 2 years, 12 hours of continuing education in pharmacology management or clinical optometry are earned. |