State of New Jersey
Department of Law and Public Safety
Division of Consumer Affairs

VOLUME 33, NUMBER 17
TUESDAY, SEPTEMBER 4, 2001
RULE PROPOSAL

LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
NEW JERSEY STATE BOARD OF OPTOMETRISTS
CONTINUING PROFESSIONAL OPTOMETRIC EDUCATION

Additions are indicated by <<+ Text +>>; deletions by <<- Text ->>.
Changes in tables are made but not highlighted.

Reproposed New Rules: N.J.A.C. 13:38-7

Authorized By: New Jersey State Board of Optometrists, Susan Gartland, Executive Director.

Authority: N.J.S.A. 45:12-4 and 45:12-9.1 through 9.5.
Proposal Number: PRN 2001-358.

Submit written comments by October 4, 2001 to:

Susan Gartland, Executive Director
New Jersey State Board of Optometrists
124 Halsey Street
PO Box 45012
Newark, New Jersey 07101

The agency proposal follows:

Summary

This proposal was originally published in the May 4, 1998 New Jersey Register at 30 N.J.R. 1513(a). Upon consideration of the comments received and Board review of the rules as proposed, the Board has decided to repropose these rules with changes from the original proposal. A summary of the comments received on the original proposal and the Board's responses follows.

The Board received written comments from the following:

1. Bruce Nitti, O.D., Union, N.J.

2. Erroll Rummel, O.D., F.A.A.O., F.C.O.V.D., of Rummel Eye Care, Jackson, N.J.

3. Michael A. Newman, O.D., of Dr. S. Newman, Dr. M.A. Newman, Optometrists, Trenton, N.J.

4. J.H. Ross, O.D., Newark, N.J.

5. Stuart M. Lonsk, O.D., P.A. of Linden, N.J.

6. Gary A. Heubel, O.D. (No address provided)

7. David L. Maitin, O.D., Deptford, N.J.

8. Joseph R. Miele, O.D., F.A.A.O., F.C.O.V.D., Middletown, N.J.

9. Lucy P. Sheffield, O.D., Haddonfield, N.J.

10. New Jersey Optometric Association (David Grimm, Executive Director), Trenton, N.J.

COMMENT: The rule does not state at N.J.A.C. 13:38-7.2(b) whether the licensee wanting to reactivate an inactive certificate must get therapeutic pharmacological agents ("TPA") credits. Perhaps the Board should clarify this language by making reference to N.J.A.C. 13:38-7.3(a), which sets forth credit requirements.

RESPONSE: The Board acknowledges that clarification is necessary in order to be consistent with the requirements for those licensees maintaining active licenses. Therefore, the language of this subsection has been amended in this reproposal to include reference to N.J.A.C. 13:38-7.3(a) as suggested by the commenter.

COMMENT: A majority of the commenters expressed concern that the Board's requirement of 50 credits per biennial period is very high compared with optometry boards in other states and other professional boards in the State of New Jersey.

RESPONSE: The biennial requirement of 50 hours of continuing education was set by the Legislature in N.J.S.A. 45:12-9.3 and is beyond the Board's discretion to change.

COMMENT: One commenter was supportive of the Board's proposal to require all licensees to obtain 50 credits of continuing professional optometric education per biennial licensing period, 20 of which shall be TPA credits and 30 of which shall be non-TPA credits.

RESPONSE: The Board appreciates the commenter's support of the continuing education program. However, the Board, upon further consideration, has decided that 25 credits should be TPA credits and 25 should be non-TPA credits. The Board has decided to increase the amount of TPA credits to 25 since, on reproposal, the Board broadened the areas in which a licensee can obtain the TPA credits.

COMMENT: The definition of TPA courses at N.J.A.C. 13:38-7.3(a) is too restrictive and the language "treatable by pharmacological agents" should be removed from this section.

RESPONSE: Although the Board acknowledges the commenter's concerns, it was the Board's intent to require specific education in the area of therapeutic pharmacological agents utilized to treat common eye ailments in order to assure that TPA-certified optometrists are obtaining the most necessary and current information in the field. Additionally, the scope of TPA courses is being broadened in this reproposal, which will expand licensee's options in fulfilling this requirement. Other courses may be taken as part of the remaining credits.

COMMENT: Two commenters stated that they were not certified to administer or dispense pharmaceutical agents. Because of this, one commenter felt that he should not have to take the 20 TPA credits that are required by the Board at N.J.A.C. 13:38-7.3(a) since it is not germane to his practice. His rationale was that if he is not certified to use TPA's, then TPA credits should not be a mandatory 40 percent of his total continuing professional optometric education requirement. He suggested that he still have the same number of credits required but that they be of non-TPA courses.

The other commenter noted that this provision might be burdensome to some of the older optometrists.

RESPONSE: On reproposal, the Board is proposing that a licensee complete 25 credits in TPA. The Board acknowledges that not all licensees are TPA- certified; however, the 25 credits in the TPA requirement is applicable to all licensees so that when the need arises, the licensees can make appropriate referrals for their patients to those licensees who are TPA-certified. Because the use of TPA has become an important aspect of the full scope of optometric practice, every optometrist must understand these topics even if he or she chooses not to obtain certification.

COMMENT: The Board is requiring that 20 credits must be in the subject area of TPA (specifically, courses on ocular pharmacology, ocular manifestation of systemic disease treatable by pharmacological agents, or ocular pathology treatable by pharmacological agents). One commenter wrote that the Board's limitations on courses acceptable to the TPA requirement at N.J.A.C. 13:38- 7.3(a) were too stringent and suggested that the Board consider TPA versus non- TPA as course classification.

The commenter also opined that the TPA requirement would discourage TPA- certified licensees from exploring other methods of treating eye problems that do not involve TPA. He believed that the proposed new rule would not encourage TPA-certified licensees to be well-rounded. He suggested that courses that deal with combinations of treatment, including, but not limited to TPA, should fulfill the TPA credit requirement. He believed that those courses that deal with TPA in conjunction with other methods of treatment would still educate as to the issue of TPA and its advances but would teach licensees how to increase their treatment options. If this is within the Board's intentions, the rule as proposed does not reflect this.

RESPONSE: Because 50 percent of the credit requirements may be in non-TPA areas, the Board believes there is ample opportunity for the TPA certified optometrist to receive credit in the areas described. In addition, the Board has broadened the scope of TPA courses in this reproposal, thereby providing licensees with more courses that will fulfill the requirement.

COMMENT: One commenter suggested that since the TPA requirement at N.J.A.C. 13:38-7.3(a) is 40 percent of the total continuing professional optometric education requirement, the Board should make sure that 40 percent of the courses they approve would fulfill the TPA requirement.

RESPONSE: The Board notes that now on reproposal, the TPA requirements are 50 percent of the total credits required. The Board has found that achieving the requisite TPA credits should not be problematic as there are many courses which currently fulfill this requirement. This will, however, be monitored by the Board toensure that there will be an adequate number of courses fulfilling the TPA requirement for licensees to choose from.

COMMENT: One commenter wrote that N.J.A.C. 13:38-7.3(f)1 was not clear and questioned whether the Board considered "videotape and audiotape" as types of correspondence courses. The commenter believed that if the Board had not, the videotapes and audiotapes should be given more credit.

RESPONSE: The Board considers correspondence, video, audio, computer media, Internet and journal courses in the same category and to be of valuable educational merit; however, the interactive nature of lectures makes them the optimal learning experience and, therefore, most continuing education credits must be earned in that manner.

COMMENT: One commenter requested that N.J.A.C. 13:38-7.3(a) permit that journal articles qualify for TPA credit if they cover TPA issues.

RESPONSE: While the Board agrees that journal articles do provide valuable educational information, the subtleties and interactions that a lecture can lend to TPA topics are essential for full understanding by licensees and for the protection of the public welfare. To that end, N.J.A.C. 13:38-7.5(b)4 has been amended in this reproposal to permit a limited number of credits from journal or correspondence-type courses. In addition, N.J.A.C. 13:38-7.4(d) 1 has been amended in this reproposal to allow licensees to obtain TPA credits from participating in any of these courses that are primarily devoted to the diagnosis, treatment and management of ocular disease, ocular pathology or the ocular manifestation of systemic disease.

COMMENT: One commenter wrote, with regard to the original proposed N.J.A.C. 13:38-7.3(f)3, that hands-on demonstrations of vision training equipment is a common and necessary practice and that he was unsure what is meant by "a list of programs offered on file with the Board."

RESPONSE: The Board agrees that the rule as proposed is unclear and has been modified to reflect that observation of equipment does not constitute an educational experience unless accompanied by a didactic lecture.

COMMENT: Five of the commenters felt that in N.J.A.C. 13:38-7.3(h), as originally proposed, the Board should allow licensees to carry over excess credit hours earned in one biennial renewal period so that they are applied to the subsequent biennial renewal period. It was suggested that licensees be permitted to carry over up to 10 surplus credits (either TPA or non-TPA) if those credits were obtained within six months of the biennial registration period.

RESPONSE: After careful consideration, the Board has reconsidered its position on the carry-over of excess credits and will allow licensees to carry over up to 20 credits into any succeeding biennial period. Any credits to be carried over shall be earned in the last one year of the biennial period and shall be applied to the continuing professional optometric education requirements and shall not be applied to the TPA requirements. Because TPA can be a rapidly changing field and to ensure that licensees have been educated with the most current information available, no TPA credits may be carried over. However, TPA courses may be carried over to fulfill the general continuing professional optometric education requirements. Of course, licensees will be responsible to maintain accurate records of courses intended for carry-over.

COMMENT: Two commenters were concerned about the pre-approval requirement in N.J.A.C. 13:38-7.4(a). One viewed it as unduly burdensome and the other requested that wherever possible the Board indicate that a course is pre- approved.

RESPONSE: The Board, upon review of this subsection, has found the wording to be unclear and inaccurate. It is the Board's intent to have courses or programs automatically approved if such courses or programs are being offered as post- graduate courses or programs in the professional skills of optometric practice and scientific courses or programs, which are accredited by the United States Department of Education and the Council on Postsecondary Accreditation or are approved by the Council on Optometric Practitioner Education ("COPE") or if the licensee completes a residency or a fellowship. It is not the Board's intent that licensees seek approval from the Board before taking a particular course. Therefore, the Board has amended the language of N.J.A.C. 13:38-7.4(b) to reflect the Board's intent.

COMMENT: One commenter wrote that he attends seminars all over the country and that the course sponsor would probably not apply for New Jersey approval under N.J.A.C. 13:38-7.4(a)2 if only one New Jersey licensee is attending. As a result, the commenter presumed that it would be unreasonable for a seminar sponsor to apply for approval for one person.

RESPONSE: As noted in the Response to the preceding Comment, licensees need not obtain pre-approval of all courses. Additionally, the Board notes that on reproposal, the Board is proposing that all COPE-approved courses are automatically approved by the Board.

COMMENT: One commenter wrote to request that courses that indirectly deal with vision be able to fulfill continuing professional optometric education requirements at N.J.A.C. 13:38-7.4(b). In particular, this licensee noted that he works in a specialized optometric field (neuro-optometric rehabilitation) in a hospital setting and that courses dealing with head injuries, strokes, balance disorders, vestibular dysfunction, etc., are applicable to his practice even though these conditions indirectly affect vision. Moreover, he regularly attends courses on these subjects. Since it is within the scope of his practice to be aware of these conditions and how they affect his role as an optometrist, he requests that these courses be applicable to the continuing professional optometric education requirements.

RESPONSE: The Board has always intended that optometrists take these kinds of courses so that they will be well informed with regard to all aspects of eye care and the traumas or disorders which can impact on the eye, as well as how those traumas or disorders manifest themselves in the eye. However, upon examination of the rule as originally proposed, the Board has determined that the wording of N.J.A.C. 13:38-7.4(b) was not clear and therefore it has been clarified in this reproposal at N.J.A.C. 13:38-7.4(a).

COMMENT: One commenter suggested that the language of N.J.A.C. 13:38-7.4(b) 1 concerning unacceptable subjects was not clear and could be clarified by changing "other matters" to "other similar matters."

RESPONSE: Upon review of the rule as proposed, the Board agrees with the commenter and has adjusted the language in this reproposal at N.J.A.C. 13:38-7.4(a)4.

COMMENT: A commenter asked whether the Board would accept seminars presented in foreign countries without prior approval pursuant to N.J.A.C. 13:38- 7.4(b)4.

RESPONSE: Since the Board has amended this reproposal to clarify that licensees need not obtain pre-approval, licensees may attend seminars presented in foreign countries without obtaining pre-approval. But in order to be granted continuing education credit, the program or course must have significant educational or practical content which deals with matters related to the practice of optometry or with the professional responsibilities or ethical obligations of licensees as outlined in N.J.A.C. 13:38-7.4(a)1 through 4. In addition, the Board proposes at N.J.A.C. 13:38-7.4(b)1 through 3, that all courses or programs offered by certain sources will automatically be approved.

COMMENT: One commenter felt that the text was unclear as to how journal articles were scored, for instance, is each journal article worth two or three credits?

RESPONSE: The Board is not certain whether this commenter is concerned with writing a journal article and submitting it for publication or if the commenter is concerned with how the Board allocates credit for correspondence-type courses that are in the form of journal articles with graded post-tests. If the commenter is referring to authoring an article, which is published in a professional refereed journal, the Board will give each licensee three credits per article or scientific presentation, pursuant to N.J.A.C. 13:38-7.5(b) 3.

However, if the commenter is referring to the correspondence-type journal course with a final examination, a maximum of two credits per course will be granted. Licensees must retain the certification of the successful final examination.

COMMENT: A majority of the commenters requested that the Board increase the number of credits that can be obtained from the following methods in N.J.A.C. 13:38-7.5(b)1 through 7: correspondence courses, Grand Round courses, hands-on courses, or clinical courses, or not limit the source of credits at all.

In general, the lecture or seminar courses were not preferred among the commenters because they did not find the instruction method suitable to their particular needs or interests; they are extremely costly; the licensees did not like the time constraints (causing licensees to miss time at work); there is not much course diversity; and the material is given in spoken form and therefore harder to retain for future use and application.

The rationale behind the requests to increase credits from correspondence courses were fairly similar: the printed nature of correspondence courses makes the information easier to file and use for future reference than the spoken material gained from lectures. Also, the correspondence courses are more economical (sometimes free of charge) and offer greater flexibility as to scheduling. Moreover, in the correspondence course format, a licensee may review material more than once if they do not understand it the first time; this is not always possible during a lecture. Additionally, the test administered at the end of the course ensures that the licensee actually learned the material.

The reasoning behind the requests to increase credits from Grand Round, hands- on, or clinical courses was that the practical experience was easier to relate to actual practice as opposed to spoken seminar material. One commenter suggested that the Grand Round courses must consist of both patient observation and case presentation. Another commenter suggested that Grand Rounds be worth one credit per hour.

In some cases, the commenters acknowledged that it is easier for the Board to ascertain attendance at seminars and lectures but felt that there was no ensuring that licensees were actually paying attention during that time.

RESPONSE: Observation of another practitioner delivering care is of limited value in the learning process. A licensee may obtain one-half credit for each hour of attendance at structured grand rounds courses offering didactic lectures. While ease of attendance may be the primary concern for many optometrists, the protection of the public is the priority of the Board and lecture attendance is still the standard in all professions for continuing education. Regarding the comment on attendees not paying attention, this is just as much of a problem with journals and tapes.

COMMENT: One commenter felt that given the work involved, under N.J.A.C. 13:38-7.5(b)7, a licensee presenting a course should get two credit hours per hour (up to 12 hours) of preparation time for new material and one credit hour per hour (up to 12 hours) for the same course given in the same year.

RESPONSE: The Board agrees with the commenter's suggestion and has reproposed this rule consistent with that suggestion.

COMMENT: Will the Board provide forms to the course sponsors to maintain the records required under N.J.A.C. 13:38-7.6(a)?

RESPONSE: No, but the Board does not prohibit sponsors from formulating a form that could be disseminated during courses or programs and could be filled in by the licensee to include the information required by N.J.A.C. 13:38-7.6(a).

COMMENT: The four-year after renewal of license recordkeeping requirement at N.J.A.C. 13:38-7.6(a) is too long.

RESPONSE: After consideration, the Board is of the belief that a four-year record retention is not unreasonable and that this recordkeeping requirement is necessary, especially since the Board is now proposing the carry-over of up to 20 excess hours into the next biennial registration period.

COMMENT: One commenter believed that requiring "the signature of a program official" at N.J.A.C. 13:38-7.6(a)7 was unnecessary and duplicative in light of other materials that must be provided to verify attendance. The commenter suggested that this requirement be removed from the rule.

RESPONSE: N.J.A.C. 13:38-7.6(a)7 is changed in this reproposal to require licensees to obtain either the signature of a course or program official or other verification of successful completion by the course or program sponsor, but not both.

COMMENT:One commenter believed that N.J.A.C. 13:38-7.8(a)3i, ii and iii were inequitable to require five years of experience for an optometrist yet to not require the same experience for a lecturer with an M.D. or Ph.D. degree. The commenter suggested that since the Board deems it important to have practical, clinical experience, all lecturers under these subsections should have five years of practical experience and that the lecturers have special expertise or certification.

RESPONSE: The Board disagrees with the commenter's reasoning; however, the Board has amended the rule so that pursuant to N.J.A.C. 13:38-7.8(a)3iii, a professional must be a licensed professional and not limited to a health care professional. In addition, the Board has determined that the specialized knowledge is the key element in presenting a continuing optometric education activity, not necessarily how long an optometrist has been practicing.

COMMENT: One commenter wanted to know whether, at N.J.A.C. 13:38-7.8(a) 3ii and iii, the Board is accepting the words "special" and "expert" to distinguish between optometrists who have uncommon knowledge in a particular area of optometry?

RESPONSE: In the context of the regulation, "special expertise" is intended to mean persons who are competent to provide instruction in a particular area as a result of training, education and experience and should not be confused with the words "specialist" and "expert." The Board is not allowing and this rule is not intended to permit licensees to refer to themselves as "specialists" or "experts."

COMMENT: Having the requirement under N.J.A.C. 13:38-7.8(d) that certificates be numbered as part of verification of attendance is unduly expensive and not necessary.

RESPONSE: The commenter is reading the section incorrectly. The number requested is the license certificate number, not the course attendance certificate. This requirement has been clarified in the reproposal at N.J.A.C. 13:38-7.6(a)1 and 7.8(e)2.

COMMENT: One commenter felt that the language in N.J.A.C. 13:38-7.8(d) is not representative of the Board's intentions. The commenter felt that the rule mistakenly requires that the licensees be given proof verifying attendance when it is actually the Board that should be getting such information. The commenter suggested that unless this follows the intentions of the Board, this language should be changed to require the sponsor to furnish to the Board upon request a verification of attendance which will be maintained for four years.

RESPONSE: The Board disagrees with the commenter that the language be changed. It is the optometrist's responsibility to document proof of course or program attendance, not the course sponsor.

COMMENT: Two commenters stated that evaluations required by N.J.A.C. 13:38- 7.8(e) are very costly and hard to make the attendees fill out. Moreover, one of the commenters felt that it "makes no sense to require such activity by regulation." Additionally, the paperwork will be an undue burden.

RESPONSE: The Board has determined that N.J.A.C. 13:38-7.8(e) will be too burdensome to implement and has, therefore, deleted that provision in this reproposal. In addition, the Board has experienced that evaluations provide little or no benefit. This, however, does not preclude a sponsor from requesting evaluations.

COMMENT: One commenter askedwhether, under N.J.A.C. 13:38-7.8(e), the Board wants a specific evaluation to be used for all courses.

RESPONSE: The Board has determined that N.J.A.C. 13:38-7.8(e) will be too burdensome to implement and has, therefore, deleted that provision in this reproposal. In addition, the Board has experienced that evaluations provide little or no benefit. This, however, does not preclude a sponsor from requesting evaluations.

COMMENT: The four-year recordkeeping requirement on course sponsors for maintaining course evaluations under N.J.A.C. 13:38-7.8(e) is too long. The commenter suggested two years instead.

RESPONSE: The Board has determined that N.J.A.C. 13:38-7.8(e) will be too burdensome to implement and has, therefore, deleted that provision in this reproposal. In addition, the Board has experienced that evaluations provide little or no benefit. This, however, does not preclude a sponsor from requesting evaluations.

COMMENT: One commenter believes the language of the second sentence in N.J.A.C. 13:38-7.8(f) is confusing due to the use of multiple negatives and that the Board should review and clarify this provision.

RESPONSE: Upon review of the proposed rule, the Board agrees that the language as proposed is not clear and has decided to amend the rule in this reproposal.

The following is a summary of the reproposed new rules:

The New Jersey State Board of Optometrists (the Board) proposes a new subchapter codified at N.J.A.C. 13:38-7 to establish continuing education requirements for optometrist in the State. The proposed new rules implement the Board's statutory provisions regarding continuing education, N.J.S.A. 45:12- 9.1 through 9.5, and further its obligation to promulgate rules which promote the safety, protection, and welfare of the public pursuant to its general rulemaking authority set forth in N.J.S.A. 45:12-4.

Proposed N.J.A.C. 13:38-7.1 requires each applicant seeking an active registration renewal certificate to confirm that the applicant has completed continuing professional optometric education credits pursuant to the provisions set forth in the subchapter. Pursuant to proposed N.J.A.C. 13:38-7.1, the Board will refuse to issue a renewal certificate to any applicant who fails to confirm that he or she has completed the mandatory continuing professional optometric education credits unless the applicant has received a valid waiver. The rule also cross-references N.J.A.C. 13:38-7.7, which sets forth the reasons and procedure for which waiver of continuing optometric credits is appropriate.

Proposed N.J.A.C. 13:38-7.2(a) exempts any licensee holding a nonactive certificate from the continuing professional optometric education requirements of the subchapter. However, N.J.A.C. 13:38-7.2(b) establishes that any licensee seeking to reactivate a nonactive certificate must provide the Board with evidence of having maintained proficiency by completing at least 50 continuing professional optometric education credits during the two calendar years immediately preceding the application for reactivation. The proposed new rule comports with the legislative intent of N.J.S.A. 45:12-9.3 which specifically mandates continuing professional optometric education for active licensees. Proposed N.J.A.C. 13:38-7.3(a) requires any holder of a nonactive certificate who desires to return to active status to comply with the minimum credit hour and category requirements for active licensees. This requirement is consistent with the statutory guidelines of N.J.S.A. 45:12-9.4 and is amended from that originally proposed based on a comment which questioned whether TPA credits must be completed.

Proposed N.J.A.C. 13:38-7.3 outlines credit hour requirements consistent with N.J.S.A. 45:12-9.3. The Board will require each applicant for an active registration renewal to provide proof of compliance with these provisions. Each applicant for an active registration renewal must complete at least 50 credits of continuing professional optometric education within the preceding biennial period; of the 50 credits, 25 credits must consist of courses or programs regarding therapeutic pharmaceutical agents and must be primarily devoted to the diagnosis, treatment and management of ocular disease, ocular pathology or the ocular manifestations of systemic disease.

Subsection (b) applies to those applicants who obtain a certificate within the first year of a biennial period. The Board will require those applicants to complete at least 25 credits, 12.5 of which shall consist of TPA programs or courses consistent with the coursework guidelines contained in subsection (a).

Subsection (c) stipulates that applicants who initially obtain a certificate within the second year of a biennial period will be exempt from continuing professional optometric education for that biennial renewal period.

Subsections (d) through (g) of the prior proposal have been recodified, reproposed and clarified at N.J.A.C. 13:38-7.4(b) and (d).

The Board originally proposed at N.J.A.C. 13:38-7.3(h) that licensees not be permitted to carry-over surplus credits from one biennial renewal period to the next. This is changed in two ways in this reproposal: first, it is recodified as N.J.A.C. 13:38-7.3(d); second, the Board is permitting a licensee to carry-over a maximum of 20 surplus credits, so long as all credits being carried over were earned in the last year of the biennial renewal period and these credits can only be applied to the continuing professional education requirements, not to TPA requirements. The Board did not allow the carry-over in the original proposed rule because of the concern that licensees would be carrying over education credits that could be outdated as optometry is an ever- changing field due to changes in technology and scientific advances. By requiring that the credits be earned close to the new biennial renewal period, the Board is ensuring that the education being credited to any biennial renewal period is relevant. Additionally, the Board is not allowing TPA credits to be carried over because that subject is constantly changing in a manner too rapid to be conducive to carry-over. It would not be consistent with the public health, safety, and welfare to permit fulfillment of the TPA requirement by carry-over of surplus credits because of the rapidity with which this area can change and the potential harm caused by licensees relying on outdated information. Thus, if a licensee has surplus credits, they will all be applied to the general continuing professional optometric education requirements.

Subsection (i) in the original proposed rule prohibits licensees from applying credit received for completing any remedial course or program toward the mandatory continuing professional optometric education requirements. This is now being recodified as subsection (e) and has been amended to more clearly define the Board's intent. This subsection is meant to apply to those licensees who either have been ordered by the Board to take continuing education as all or part of a disciplinary or remedial matter or to remediate a deficiency in continuing professional optometric credits for a prior biennial renewal period. In these cases, licensees who are so ordered by the Board may not apply the credits earned to continuing professional optometric education requirements in the current biennial renewal period or carry these credits over into the next biennial renewal period. The substance of this subsection has not changed but has been clarified.

As originally proposed, N.J.A.C. 13:38-7.4 required that licensees obtain pre-approval from the Board for all continuing professional optometric education courses or programs with the exception of post-graduate coursework completed in United States Department of Education and Council on Postsecondary Accreditation-accredited programs, programs offered by a sponsor which has already obtained approval of the Board, courses approved by the Council on Optometric Practitioner Education, and when the Board determines that prior approval of a course was not reasonably obtainable. This section, however, generated comments which indicated a great deal of confusion and concern regarding the practicability of the requirement. Moreover, the Board's intent was not to require that licensees seek pre-approval, but rather that they have some criteria as to what continuing optometric education sources and providers are automatically deemed approved. Therefore, subsection (a) is reproposed to clearly delineate what sources and providers are automatically approved for continuing professional optometric education activities. N.J.A.C. 13:38- 7.4(a)1 through 4 establishes that the Board will grant continuing professional optometric education credit for courses or programs that have significant educational or practical content which deal with matters related to the practice of optometry or with the professional responsibilities or ethical obligations of licensees such as: clinical optometry; ocular disease and management; related systemic disease and optometric practice management (except that estate planning, financial or investment/tax planning, personal health, the selling of ophthalmic materials, or other similar subjects will not be acceptable for credit). This exception is consistent with the spirit and intent of continuing optometric education: that a person licensed as an optometrist take part in activities that are directly related to the practice of optometry so that he or she keeps abreast of changes in technology and scientific advances and will seek constant professional growth as an optometrist.

Subsection (b) was originally proposed as N.J.A.C. 13:38-7.3(d) and 7.4(a). Reproposed subsection (b) combines these two subsections and deletes some language for clarification purposes. As a result, subsection (b) delineates the particular areas in which it will accept maximum acceptable credits. Subsection (b) enables licensees to obtain all of the required continuing education credits for completion of post-graduate courses or programs in the professional skills of optometric practice and scientific courses or programs, which are accredited by the United States Department of Education and the Council on Postsecondary Accreditation; for continuing professional optometric education courses or programs that consist of educational and scientific courses, which are approved by COPE; or for a residency, which is defined as a one year post-OD training program at an accredited college of optometry, or a fellowship, which is defined as a one year post-residency training program at an accredited college of optometry in a specialty area these programs are all deemed to be automatically approved.

Subsection (c) establishes that a sponsor may obtain pre-approval by the Board for programs or courses that are three credits or less. Subsection (c) requires a sponsor to submit an application, provided by the Board, no less than 45 days prior to the date the program or course is to be offered. In addition, such course or programs must comply with N.J.A.C. 13:38-7.8 and cover topics outlined at N.J.A.C. 13:38-7.4(a).

Subsection (d) establishes a maximum of 20 credits for certain types of activities whose format differs from the standard didactic lecture. The language has been clarified on reproposal to indicate that the 20 credit maximum is cumulative for paragraphs (d)1 through 7, so licensees may not apply more than 20 credits per biennial renewal period from all of these types of courses combined. Additionally, up to 10 of the licensee's TPA credits may be earned from this type of educational activity provided that these courses are primarily devoted to the diagnosis, treatment and management of ocular disease, ocular pathology, or the ocular manifestation of systemic disease.

Paragraph (d)1 deals with correspondence-type courses in which the licensee requests materials and takes a test at the end of either viewing, listening to, or reading the information transmitted. The reproposed paragraph (d)1 differs from that originally proposed in that the Board has included three new types of courses that were not included in the original proposal: journal courses, Internet courses and computer media. These were always considered by the Board to be under the ambit of "correspondence courses" but the Board decided, based on comments received that the rule needed clarification. Additionally, paragraph (d)1 is further amended from the original proposal by limiting the amount of credits licensees can earn from this specific type of "non-lecture" activity and to make clear that this type of course could be applied to the TPA requirement of N.J.A.C. 13:38-7.3(a).

N.J.A.C. 13:38-7.4(d)2 allows licensees to apply structured grand rounds to continuing professional optometric education requirements, including the TPA requirements, subject to the limitations set forth in subsection (d). Additionally, the language has been slightly altered from that originally proposed to make the subsection read more clearly.

Paragraph (d)3 has been amended on reproposal. First, the language from the original proposal has been amended to read more clearly. Second, the subsection originally read that hands-on demonstrations of instrumentation could fulfill continuing optometric education requirements. This has been amended to indicate that hands-on demonstrations of instrumentation include a didactic lecture. This has always been a requirement; however, it was not stated in the previous proposal, so in order to clarify the subsection, this proviso has been added. Additionally, the Board has determined that hands-on demonstrations of instrumentation may be used to fulfill any part of the TPA requirements as long as they are primarily devoted to the diagnosis, treatment and management of ocular disease, ocular pathology or the ocular manifestations of systemic disease.

Paragraph (d)4 permits interactive workshops which include demonstrations and applications of hands-on techniques and skills in optometric procedures and instrumentations accompanied by didactic lectures. Again, TPA credits may be obtained from participating in interactive workshops that are primarily devoted to the diagnosis, treatment and management of ocular disease, ocular pathology or the ocular manifestations of systemic disease. This activity was not originally proposed, but the Board considers interactive workshops as an appropriate method to receive continuing education credits.

Paragraph (d)5 recodifies what was originally proposed as N.J.A.C. 13:38- 7.3(g), allowing the preparation and presentation of an approved continuing optometric education lecture to count toward continuing optometric education requirements. This paragraph logically fits in with the other activities under N.J.A.C. 13:38-7.4(d); therefore, it has been included with these activities rather than as a separate subsection. Additionally, the Board is allowing this type of activity to count toward the TPA requirements so long as the lecture does in fact deal with TPA.

Paragraph (d)6 permits a licensee to obtain continuing professional optometric education credits for preparing an educational or scientific article authored and published in a professional refereed journal. Again, TPA credits may be obtained from participating in this activity as long as the article is primarily devoted to the diagnosis, treatment or management of ocular disease, ocular pathology or the ocular manifestation of systemic disease.

Paragraph (d)7 was originally proposed as N.J.A.C. 13:38-7.3(e). Licensees may receive a maximum of 10 credits per biennial renewal period for management/managed care courses relating to optometry. The Board intends that its licensees become familiar with more up-to-date practices and provide continuing optometric education credit for this type of course, since consumers benefit from smoothly running, efficient optometric practices. However, the Board has placed a limit on how many credits may be applied from this type of course because there are minimal health, safety, and welfare benefits derived from these subjects. Therefore, while the Board wants to encourage optometrists to take these types of courses, it is not intended that licensees obtain the majority of their credits from them.

Proposed N.J.A.C. 13:38-7.5 is a comprehensive outline of acceptable sources of continuing professional optometric education credit as well as the number of credits which the Board will award for each source. Pursuant to N.J.A.C. 13:38-7.5(a), all courses or programs must be at least one instructional hour in length, and licensees must complete the entire course or segment of course instruction in order to receive credit for attendance. Moreover, to obtain credit for an activity, each hour for which credit is claimed must contain at least 50 minutes of educational instruction.

Subsection (b) specifies acceptable programs and courses and the corresponding amount of credit which may be awarded. On reproposal, the Board decided to merge originally proposed N.J.A.C. 13:38-7.5(b)2 with N.J.A.C. 13:38- 7.5(b)1. N.J.A.C. 13:38-7.5(b)1 is broader than what was originally proposed and establishes that the Board will grant one credit for each hour of attendance at continuing professional optometric courses or programs. N.J.A.C. 13:38-7.5(b)2, which was originally proposed as N.J.A.C. 13:38-7.5(b)3, sets forth that licensees will receive three credits for each course credit awarded in a post-graduate program related to the profession of optometry. N.J.A.C. 13:38-7.5(b)3, which was originally proposed as N.J.A.C. 13:38-7.5(b)4, allows a licensee to receive three credits per article for each article published in a professional journal within the preceding biennial period. On reproposal, N.J.A.C. 13:38-7.5(b)4, which was originally proposed as N.J.A.C. 13:38-7.5(b)5, has been amended to establish that the Board will award a maximum of two credits per course for videotape, audiotape, computer media, Internet, journal, and correspondence courses. As originally proposed, this rule was not consistent with the rest of the paragraph because it did not establish the allowable maximum amounts of credit for correspondence courses. Instead, it gave the Board the authority to determine the amount of credit based upon the program provider's submission; therefore, in order to avoid discretionary review, the Board amended this rule. In addition, the original proposal set forth that a licensee would only be granted continuing professional optometric education credit upon the successful completion of a final examination. This concept has been deleted from this section and moved to N.J.A.C. 13:38-7.4(d)1. Pursuant to N.J.A.C. 13:38-7.5(b)5, which was originally proposed as N.J.A.C. 13:38-7.4(b) 6, the Board will offer one-half credit for each hour of attendance at structured grand rounds and hands-on demonstrations of instrumentation. In addition, N.J.A.C. 13:38-7.5(b)6 establishes that the Board will grant one credit for each hour of attendance at an interactive workshop. Pursuant to N.J.A.C. 13:38-7.5(b)7, a licensee will also be granted two credits for each hour of a new presentation of a continuing professional optometric education lecture or course. A licensee may earn up to a maximum of 12 credits in this area. The Board defines "new" for purposes of the rule as a course or program that a licensee has not taught previously in any educational setting. Additionally, paragraph (b)7 has been amended in this reproposal to allow licensees to present a course involving substantially the same subject matter more than one time in a biennial renewal period. To get credit in this instance, the licensee must show that the course has been updated as necessary. The licensee may obtain one credit for each hour of presenting subsequent sessions of a previously prepared course, up to a maximum of 12 credits per biennial renewal period. However, licensees are still subject to the 20-credit maximum limitation for all activities listed under N.J.A.C. 13:38-7.4(d). Also, on reproposal, the Board has included N.J.A.C. 13:38-7.5(b)8 which states that a licensee may earn 25 credits, of which 12.5 will be granted in TPA upon completing a residency or fellowship.

N.J.A.C. 13:38-7.6 is being amended in this reproposal to clarifythe documentation that licensees must maintain after completing a continuing professional optometric education activity. Licensees must keep all records for at least four years following the renewal period. N.J.A.C. 13:38-7.6(a) requires each licensee to maintain a record of all continuing professional optometric education activity and to be prepared to submit it to the Board upon request at any time. In response to comments received, subsection (a) has been changed from the original proposal to require licensees to include their Board- issued license number, as well as retaining the course outline and curriculum vitae for those courses or programs not approved pursuant to N.J.A.C. 13:38- 7.4(b) and (c).

In addition, N.J.A.C. 13:38-7.6(b) establishes that licensees must retain official transcripts of academic coursework as well as, pursuant to subsection (c), the certification of the successful final examination completed at the end of videotape, audiotape, computer media, Internet, journal, or correspondence course.

Pursuant to N.J.A.C. 13:38-7.6(d), in order to monitor compliance with the mandatory continuing professional optometric education requirements, the Board is proposing on reproposal that it can conduct a random audit, rather than a discretionary request, of its licensees to provide proof of successful completion of continuing professional optometric education credits.

The Board addresses waiver of continuing professional optometric education requirements in proposed N.J.A.C. 13:38-7.7. A licensee may obtain a waiver by providing a written request to the Board together with specific reasons for the request and any supporting documentation as the Board may require. The Board may grant a waiver for hardship such as severe illness, disability, or active military service.

Proposed N.J.A.C. 13:38-7.8 delineates responsibilities of continuing education sponsors for courses or programs with three credits or less. A sponsor seeking pre-approval for a course or program of three credits or less course or program must provide the Board, no less than 45 days prior to the course date, information to demonstrate that the subject matter of the course is acceptable, the course is at least one hour long, but not more than three instructional hours in length, and is conducted by an instructor or discussion leader who submits a curriculum vitae and is either an optometrist with at least five years of experience in the lecture subject matter; an individual holding an O.D., M.D., Ph.D., or a substantially equivalent international degree who is either board certified or has special expertise in the lecture subject matter; or a licensed professional who has special expertise in the lecture subject matter. In addition, the Board has determined that the specialized knowledge is the key element in presenting a continuing optometric education activity, not necessarily how long an optometrist has been practicing. Additionally, the language at subparagraphs (a)3i through iii has been slightly altered to make it read more clearly and logically. More specifically, the words "and obtains Board-approval" has been deleted and the Board is proposing at N.J.A.C. 13:38-7.8(a)3iii that an individual be a licensed professional, not a health care professional.

Subsection (b) requires that course sponsors submit applications for pre- approval to the Board no less than 45 days prior to the date the course or program is being offered. Applications received less than 45 days prior to the date the course or program is being offered will not be accepted by the Board for pre-approval. Incomplete applications will be returned to the sponsor and may result in the failure to grant pre-approval of the course or program. The concept that the failure to obtain prior approval shall not preclude acceptance of the program, has been deleted from N.J.A.C. 13:38-7.8(b) and recodified as N.J.A.C. 13:38-7.8(c).

Subsection (c) establishes that the Board will not grant post approval to a sponsor for a course or program; however, theBoard may grant a licensee post approval, upon audit, continuing professional optometric education credit for courses or programs which have not been pre-approved if the Board determines that the course or program has significant educational or practical content which is related to the practice of optometry or with the professional responsibilities or ethical obligations of licensees, such as those areas outlined in N.J.A.C. 13:38-7.4.

On reproposal, subsection (c) is recodified as subsection (d) and establishes that a course sponsor must not make substantive changes to an approved course after approval has been granted by the Board, without notifying the Board of the change and obtaining additional pre-approval of the course or program as modified. "Substantive changes" include a change in course content or instructor.

Subsection (d), which on reproposal has been recodified as subsection (e), requires each sponsor to monitor attendance. On reproposal, the Board has required additional information that each sponsor must furnish to each enrollee to verify attendance. More specifically, the sponsor must furnish the title, subject matter, name of instructor, date and location of course or program; name and license number of each attendee; number of continuing education hours and credits awarded; and the name of the sponsor and signature of officer or responsible party or other verification of successful completion by the course or program sponsor.

This section as originally proposed contained a subsection (e) that required each sponsor to solicit evaluations from both the instructor and the participants at the end of the course or program, and to retain those evaluations for at least four years from the course or program date. Comments received indicated that this is not practicable and, therefore, the Board has omitted this requirement from the reproposal.

Subsection (f) requires courses be offered on a non-discriminatory basis, but allows professional organizations providing courses to give discounts based on membership so long as the discount comports with N.J.S.A. 45:12-9.2 and allows agencies to provide courses only to their employees. The language of this subsection has been clarified based on comments received that took the position found the language as originally proposed was confusing.

Social Impact

The proposed new rules will have a positive social impact upon consumers who utilize the services of licensed optometrists. The rules ensure that optometrists supplement their knowledge and education on an ongoing basis and demonstrate proficiency in the diagnosis, treatment and management of ocular disease, ocular pathology or the ocular manifestation of systemic disease.

The proposed new rules will have an impact upon licensed optometrists who must commit time to complete the continuing professional optometric education credits and to maintain adequate documentation. However, the proposed new rules will also provide a benefit to optometrists in terms of increased professional knowledge and to the consumer who receives optometric services from highly qualified, capable, and well-informed professionals. Thus, the new rules weigh strongly in favor of the public interest and furnish the Board with provisions to enforce continuing competency requirements pursuant to its legislative authority.

Economic Impact

The proposed new rules have an economic impact upon the approximately 1,230 optometrists licensed in the State at this time who will incur ongoing costs to complete continuing professional optometric education courses or programs. The cost to each licensee will vary depending upon the course or program which each individual licensee selects to satisfy the continuing education requirements.

The Board does not anticipate that the new rules will cause optometrists to increase their fees in order to recoup the costs of maintaining professional competence. Moreover, the overwhelming benefit of continuing competency to both the licensee and the general public weighs strongly in favor of the rules.

Federal Standards Statement

A Federal standards analysis is not necessary as there are no Federal standards or requirements which address the subject matter. The Board proposes these rules pursuant to State statutes governing the profession.

Jobs Impact

The proposed new rules will impact each applicant for an active registration renewal certificate who fails to substantiate completion of the mandatory continuing professional optometric education credits. The proposed new rules establish that the Board will not issue an active registration renewal certificate to any optometrist who fails to complete the minimal continuing competency credits. The Board believes that potential denial of an applicant's request for an active registration renewal certificate will encourage compliance with the rules.

The proposed new rules have a positive impact upon jobs for continuing education lecturers and program sponsors who will administer the various offerings.

Agriculture Industry Impact

The Board does not anticipate that the proposed new rules will have any impact on the agriculture industry in the State.

Regulatory Flexibility Analysis

The Regulatory Flexibility Act (the Act), N.J.S.A. 52:14B-16 et seq., requires the Board to give a description of the types and an estimate of the number of small businesses to which the proposed new rules will apply. If licensed optometrists and program sponsors are considered "small businesses" for the purposes of the Act, the following analysis applies.

The Act requires the Board to set forth the reporting, recordkeeping, and other compliance requirements of the proposed new rules including the kind of professional services likely to be needed to comply with the requirements. The Act further requires the Board to estimate the initial and annual compliance costs of the proposed new rules, and to provide an indication of the likely variation on small businesses of differing types and sizes. In addition, the Act requires the Board to outline the manner in which it has designed the rules to minimize adverse economic impact upon small businesses.

The proposed new rules impose minimal reporting and recordkeeping requirements upon licensees. With respect to reporting requirements, each licensee who applies for an active registration renewal certificate must, pursuant to N.J.A.C. 13:38-7.1, indicate on the renewal application that he or she has completed the appropriate number and type of continuing professional optometric education credits. A licensee who seeks a waiver of continuing professional optometric education requirements, pursuant to N.J.A.C. 13:38-7.7, must submit a detailed explanation for the waiver request together with any necessary supporting documentation. In addition, the proposed new rules require program sponsors, who are offering a course or program awarding three credits or less to submit information to the Board as set out at N.J.A.C. 13:38- 7.8(a).

With respect to recordkeeping requirements, the proposed new rules require at N.J.A.C. 13:38-7.6 that licensees keep records verifying completion of the requirements for at least four years following the renewal.

To further comply with the proposed new rules, N.J.A.C. 13:38-7.3 requires that licensees must complete courses or programs in the content areas which the Board sets forth at N.J.A.C. 13:38-7.4. Sponsors must notify the Board of substantive changes to approved courses or risk that approval will be withdrawn pursuant to N.J.A.C. 13:38-7.8(d).

The proposed new rules establish that the Board will approve professional program sponsors and lecturers who offer programs or courses of three credits or less. Program providers will incur initial program development costs and amounts necessary to provide adequate physical facilities and qualified instructors according to the standards. Licensees will also incur an ongoing cost to complete continuing professional optometric education courses and programs which will vary depending upon which qualified program a licensee selects. Because the Board intends to maintain a minimum level of proficiency among all licensed optometrists, no exception is possible except in cases of undue hardship such as severe illness, disability, or military service as set out in N.J.A.C. 13:38-7.7. Ultimately, any costs which the proposed new rules impose upon licensees are strongly outweighed by their positive impact upon the health, welfare, and safety of the public. The Board has designed the proposed new rules to minimize adverse economic impact upon licensees by allowing them to select from a number of different continuing professional optometric education courses or programs which will be offered at varying costs in order to meet the minimum requirements. The Board does not anticipate that the proposed rules will require the use of additional professional services by small businesses. Additionally, the proposed new rules are intended to be uniformly applied and, therefore, there are no differing compliance requirements available to any licensee or course sponsor. Thus, the proposed amendments are reasonable and are designed to minimize adverse economic impact upon small businesses.

Full text of the reproposed new rules follows:

<<+SUBCHAPTER 7. CONTINUING PROFESSIONAL OPTOMETRIC EDUCATION+>>

<< NJ ADC 13:38-7.1 >>

<<+13:38-7.1 Active registration renewal; continuing education requirement+>>

<<+Any applicant who applies for an active registration renewal certificate for a biennial period shall confirm on the renewal application that the applicant has completed continuing professional optometric education programs of the types and number of credits specified in N.J.A.C. 13:38-7.3. The Board shall not issue an active registration renewal certificate to any applicant who fails to confirm that the applicant has completed the continuing professional optometric education requirements unless the Board issues the applicant a waiver pursuant to N.J.A.C. 13:38-7.7.+>>

<< NJ ADC 13:38-7.2 >>

<<+13:38-7.2 Nonactive registration renewal and reactivation of license; continuing education requirement+>>

<<+(a) Any licensee who has a nonactive certificate shall be exempt from the continuing professional optometric education requirements set forth in this subchapter.+>>

<<+(b) Any licensee seeking to reactivate a nonactive certificate shall provide the Board with evidence of having maintained proficiency by completing the professional optometric education requirements set forth at N.J.A.C. 13:38-7.3(a) during the two calendar years immediately preceding the application for reactivation.+>>

<< NJ ADC 13:38-7.3 >>

<<+13:38-7.3 Credit hour requirements+>>

<<+(a) An applicant for an active registration renewal certificate shall complete, during the preceding biennial period, a minimum of 50 credits of continuing professional optometric education. At least 25 of the 50 credits shall consist of courses or programs classified as therapeutic pharmaceutical agents (TPA) credits and shall be primarily devoted to the diagnosis, treatment and management of ocular disease, ocular pathology or the ocular manifestation of systemic disease. The remaining general continuing professional optometric education credits shall be in content areas set forth in N.J.A.C. 13:38- 7.4.+>>

<<+(b) An applicant who initially obtains a certificate within the first year of a biennial period shall complete at least 25 of the minimum required credits of continuing professional optometric education. At least 12.5 of the 25 credits shall consist of courses or programs classified as TPA credits and shall be devoted to the subject matter set forth in (a) above.+>>

<<+(c) An applicant who initially obtains a certificate within the second year of a biennial period shall be exempt from completing continuing professional optometric credits for that biennial renewal period.+>>

<<+(d) A licensee who completes more than the required 50 credits in any biennial period may carry up to 20 credits into any succeeding biennial period. Any credits to be carried over shall be earned in the last one year of the biennial renewal period and shall be applied to the continuing professional optometric education requirements and shall not be applied to the TPA requirements.+>>

<<+(e) Any continuing education courses or programs directed or ordered by the Board to be taken by a licensee as all or part of a disciplinary or remedial measure or to remediate a deficiency in continuing professional optometric education credits for a prior biennial renewal period shall not be eligible to fulfill the mandatory continuing professional optometric education requirements for a subsequent biennial renewal period as set forth in this subchapter.+>>

<< NJ ADC 13:38-7.4 >>

<<+13:38-7.4 Approved course offerings+>>

<<+(a) The Board shall grant continuing professional optometric education credit only for courses or programs that have significant educational or practical content which deal with matters related to the practice of optometry or with the professional responsibilities or ethical obligations of licensees, such as the following:+>>

<<+1. Clinical Optometry: general optometry; contact lenses; ophthalmic lens design; low vision; functional vision; principals of diagnosis; HIV control; infection control;+>>

<<+2. Ocular Disease and Management: treatment and management of ocular disease: anterior segment; treatment and management of ocular disease: posterior segment; glaucoma; refractive surgery management; peri-operative management of ophthalmic surgery;+>>

<<+3. Related Systemic Disease: ocular/systemic disease; pharmacology; and+>>

<<+4. Optometric Practice Management: jurisprudence; practice management; managed care courses or programs related to the practice of optometry, except that estate planning, financial or investment/tax planning, personal health, the selling of ophthalmic materials, or other similar subjects shall not be acceptable for credit.+>>

<<+(b) All courses or programs offered by the following sources and providers shall be deemed to be automatically approved and a licensee may obtain all 50 continuing professional optometric education credits from the following:+>>

<<+1. Post-graduate courses or programs in the professional skills of optometric practice and scientific courses or programs, which are accredited by the United States Department of Education or the Council on Postsecondary Accreditation;+>>

<<+2. Continuing professional optometric education courses or programs that consist of educational and scientific courses, which are approved by the Council on Optometric Practitioner Education (COPE); or+>>

<<+3. A residency, which is a one year post-OD training program at an accredited college of optometry, or a fellowship, which is a one year post- residency training program at an accredited college of optometry in a specialty area.+>>

<<+(c) Sponsors submitting applications for pre-approval of continuing professional optometric education programs or courses which award three credits or less shall submit to the Board, on a form provided by the Board, no less than 45 days prior to the date the program or course is to be offered. Such courses or programs shall be in compliance with N.J.A.C. 13:38-7.8 and cover topics outlined at (a) above.+>>

<<+(d) The Board shall grant a maximum of 20 of the mandatory 50 continuing professional optometric education credits, including a maximum of 10 of the mandatory 25 TPA credits required, from any or all of the following:+>>

<<+1. Videotape, audiotape, computer media, Internet, journal, or correspondence courses or programs. The course or program shall include an examination at the end of the course or program. Credit for correspondence and other individual study courses or programs will be given only in the renewal period in which the course is completed with a successful final examination. TPA credits may be obtained from participating in any of these courses that are primarily devoted to the diagnosis, treatment and management of ocular disease, ocular pathology or the ocular manifestation of systemic disease;+>>

<<+2. Structured grand rounds, which is a presentation, with a formal outline of course or program material, of clinical cases involving actual patient encounters and the lecture and discussion of the diagnosis and treatment of the particular patient condition. Non-structured grand rounds that consist of observation of individual patient care shall not be accepted for credit. TPA credits may be obtained from participating in structured grand rounds that are primarily devoted to the diagnosis, treatment and management of ocular disease, ocular pathology or the ocular manifestation of systemic disease;+>>

<<+3. Hands-on demonstrations of instrumentation when accompanied by didactic lectures. TPA credits may be obtained from participating in hands-on demonstrations of instrumentation that are primarily devoted to the diagnosis, treatment and management of ocular disease, ocular pathology or the ocular manifestation of systemic disease;+>>

<<+4. Interactive workshops which include demonstrations and applications of hands-on techniques and skills in optometric procedures and instrumentations accompanied by didactic lectures. TPA credits may be obtained from participating in interactive workshops that are primarily devoted to the diagnosis, treatment and management of ocular disease, ocular pathology or the ocular manifestation of systemic disease;+>>

<<+5. Preparation and presentation of a continuing professional optometric education lecture. TPA credits may be obtained from preparing and presenting continuing professional optometric education lectures that are primarily devoted to the diagnosis, treatment and management of ocular disease, ocular pathology or the ocular manifestation of systemic disease;+>>

<<+6. Preparation of an educational or scientific article authored and published in a professional refereed journal. TPA credits may be obtained from preparing an educational or scientific article authored and published in a professional refereed journal that is primarily devoted to the diagnosis, treatment and management of ocular disease, ocular pathology or the ocular manifestation of systemic disease; or+>>

<<+7. The Board shall grant a maximum of 10 continuing professional optometric education credits per biennial renewal period for optometric practice management or managed care courses or programs relating to the practice of optometry. Continuing professional optometric education credit shall not be granted in courses or programs taken in the following subjects: estate planning, financial or investment/tax planning, personal health, the selling of ophthalmic materials, or other similar subjects.+>>

<< NJ ADC 13:38-7.5 >>

<<+13:38-7.5 Sources of continuing professional optometric education credit and credit-hour calculation+>>

<<+(a) The Board shall grant credit only for continuing professional optometric education courses or programs that are at least one instructional hour long. For purposes of this subchapter, an "instructional hour" represents a 60-minute clock hour with no less than 50 minutes of educational content within the hour. Courses or programs may include one 10-minute break for each instructional hour. Successful completion of an entire course segment of instruction is required in order to receive any continuing professional optometric education credit for that segment.+>>

<<+(b) The Board shall grant a licensee continuing professional optometric education for each biennial period as follows:+>>

<<+1. Attendance at continuing professional optometric education courses or programs: one credit for each hour of attendance;+>>

<<+2. Coursework in a post-graduate educational program related to the profession of optometry: three credits for each course credit awarded;+>>

<<+3. Authoring an educational or scientific article authored and published in a professional refereed journal within the preceding biennial period: three credits per article;+>>

<<+4. Successful completion of videotape, audiotape, computer media, Internet, journal, and correspondence courses or programs: a maximum of two credits per course;+>>

<<+5. Structured grand rounds and hands-on demonstrations of instrumentation: one-half credit for each hour of attendance;+>>

<<+6. Interactive workshops: one credit for each hour of attendance;+>>

<<+7. Preparation and presentation of a continuing professional optometric education lecture course or program: two credits for each hour of a new presentation up to a maximum of twelve credits. For purposes of this paragraph, "new" represents a course or program that the licensee has not taught previously in any educational setting. One credit for each hour of a presentation shall be given for subsequent sessions involving substantially identical subject matter up to a maximum of 12 credits, provided the original material has been updated and subject to the credit limits of N.J.A.C. 13:38-7.4(d); and+>>

<<+8. A residency or a fellowship, as defined in N.J.A.C. 13:38-7.4(b) 3: 25 credits, of which 12.5 shall be TPA credits, upon completing each residency or fellowship.+>>

<< NJ ADC 13:38-7.6 >>

<<+13:38-7.6 Documentation of continuing professional optometric education credit+>>

<<+(a) Each licensee shall maintain a record of all continuing professional optometric education activity completed and shall submit evidence of completion of the credit requirements to the Board upon request. Each licensee shall obtain from the continuing education course or program sponsor and retain for a period of at least four years following the renewal a record of attendance which shall include, at a minimum, the following:+>>

<<+1. The participant's name and New Jersey State Board of Optometrists license number;+>>

<<+2. The title and subject matter of the course;+>>

<<+3. The name of the instructor;+>>

<<+4. The course or program sponsor;+>>

<<+5. The date and location of the course or program;+>>

<<+6. The number of continuing education hours and credits awarded;+>>

<<+7. The signature of a course or program official or other verification of successful completion by the course or program sponsor; and+>>

<<+8. The course outline and curriculum vitae for those courses or programs not approved pursuant to N.J.A.C. 13:38-7.4(b) and (c).+>>

<<+(b) A licensee shall verify completion of academic coursework by an official transcript.+>>

<<+(c) A licensee who completes a videotape, audiotape, computer media, Internet, journal, or correspondence course or program shall retain the certification of the successful final examination completed at the end of the course or program.+>>

<<+(d) The Board shall monitor compliance with the mandatory continuing professional optometric education requirement by conducting a random audit of licensees, who, upon request shall provide proof of successful completion of continuing professional optometric education credits.+>>

<< NJ ADC 13:38-7.7 >>

<<+13:38-7.7 Waiver of continuing professional optometric education requirements+>>

<<+(a) The Board may waive continuing professional optometric education requirements on an individual basis for reasons of hardship such as illness, disability, active service in the military, or other good cause.+>>

<<+(b) A licensee who seeks a waiver of the continuing professional optometric education requirements shall provide to the Board, in writing, the specific reasons for requesting the waiver and such additional information as the Board may request in support of the waiver.+>>

<< NJ ADC 13:38-7.8 >>

<<+13:38-7.8 Responsibilities of continuing education sponsors for courses/programs with three credits or less+>>

<<+(a) A continuing education sponsor seeking pre-approval for a course/ program awarding three credits or less shall provide the Board, in writing on a form provided by the Board, information which demonstrates that the course meets the following requirements:+>>

<<+1. The course or program is offered in a subject matter and in a format permissible pursuant to the provisions of this subchapter;+>>

<<+2. The course or program is at least one instructional hour in length, but not more than three instructional hours in length; and+>>

<<+3. The course or program is conducted by an instructor or discussion leader who submits a curriculum vitae and meets one of the following criteria:+>>

<<+i. An optometrist with at least five years of experience in the lecture subject matter;+>>

<<+ii. An individual holding an O.D., M.D., Ph.D. or a substantially equivalent international degree who is either board certified or has special expertise in the lecture subject matter; or+>>

<<+iii. A licensed professional who has special expertise in the lecture subject matter.+>>

<<+(b) Applications for pre-approval of continuing professional optometric education courses or programs shall be submitted by the course or program sponsor on the form provided by the Board no less than 45 days prior to the date the course or program is to be offered. Incomplete applications shall be returned to the sponsor and may result in the failure to grant pre-approval of the course or program.+>>

<<+(c) The Board shall not grant post approval to a sponsor for a course or program; however, the Board may grant a licensee, upon audit, continuing professional optometric education credit for courses or programs which have not been pre-approved if the Board determines that the course or program has significant educational or practical content which deal with matters related to the practice of optometry or with the professional responsibilities or ethical obligations of licensees, such as those areas outlined in N.J.A.C. 13:38- 7.4.+>>

<<+(d) The sponsor shall not make substantive changes to an approved course or program, such as a change in course content or instructor, without prior notice to and pre-approval by the Board.+>>

<<+(e) The sponsor shall monitor attendance at each approved course or program and furnish to each enrollee a verification of attendance, which shall include at least the following information:+>>

<<+1. The title, subject matter, name of instructor, date, and location of course or program;+>>

<<+2. The name and New Jersey State Board of Optometrists license number of each attendee;+>>

<<+3. The number of continuing education hours and credits awarded; and+>>

<<+4. The name of the sponsor and signature of officer or responsible party or other verification of successful completion by the course or program sponsor.+>>

<<+(f) Continuing education courses or programs shall be offered on a nondiscriminatory basis. Membership organizations may discount the cost of attending continuing professional optometric education courses or programs for dues-paying members provided the fee differential complies with N.J.S.A. 45:12-9.2.+>>

33 N.J.R. 2947(a)


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Posted September 2001