2100 Board of Examiners in Optometry

Delaware General Assembly : Delaware Regulations : Administrative Code : Title 24

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Division of Professional Regulation

2100 Board of Examiners in Optometry

1.0 Qualifications for Licensure

1.1 All candidates candidate shall pass all sections of the examination given by the National Board of Examiners in Optometry.

1.2 All candidates must be CPR certified for both children and adults and maintain their certification while licensed.

19 DE Reg. 204 (09/01/15)

27 DE Reg. 620 (02/01/24)

2.0 Internship/Temporary Licensee

2.1 An internship is a course of study in which applicants receive part of their clinical training in a Board approved private practice setting in Delaware, or other Board approved setting, under the supervision of a licensed optometrist or ophthalmologist. An active, licensed optometrist or ophthalmologist may act as a supervisor. Any applicant’s participation in such an internship program must be approved by the Board and is subject to the following terms and conditions:

2.1.1 A letter from the practitioner with whom the applicant will be interning stating the goals, duties and the number of hours the applicant will be working.

2.1.2 Each applicant must provide the name and address of the supervisor and the dates of the internship for approval by the Board before the internship may begin provided that, in the event an applicant has made a good faith effort to submit all necessary licensure materials for approval of the internship, and the Board is unable to meet to review said licensure materials the Board may approve said internship starting as of the date when the applicant has submitted all licensure materials.

2.1.3 A letter must be received by the Board from the supervisor verifying the completion of the internship.

2.1.4 For purposes of this Section and 29 Del.C. §2110, the term “duration” shall be defined as “a period of no less than 6 months and no greater than the period ending on the date of the next Board meeting following the end of the 6 month period.” No intern may practice on a temporary license beyond the duration of the internship.

2.2 Full-time: minimum of 35 hours per week.

2.3 All supervisors must supervise the interns on a 1-to-1 basis whenever an applicant performs a task that constitutes the practice of optometry. No supervisor may be a supervisor for more than 1 intern, or student extern, during the period of the internship or externship.

2.4 All acts that constitute the practice of optometry under 24 Del.C. §2101(a) may be performed by the intern only under the following conditions:

2.4.1 The supervisor shall be on the premises and immediately available for supervision at all times;

2.4.2 All intern evaluations of any patient shall be reviewed by the supervisor prior to final determination of the patient’s case before the patient leaves the premises; and

2.4.3 A supervisor shall at all times effectively supervise and direct the intern.

2.5 A violation of any of the conditions enumerated in this rule may be grounds for the Board to revoke its approval of an internship program. The Board may also revoke its approval of an internship program if it determines that either the supervising optometrist or the intern has engaged in any conduct described by 24 Del.C. §2113(a). Furthermore, any violation of the terms of this rule by a supervising optometrist who is a licensed optometrist shall be considered unprofessional conduct and a violation of 24 Del.C. §2113(a)(7).

2 DE Reg 85 (05/01/99)

7 DE Reg. 912 (01/01/04)

8 DE Reg. 536 (10/01/04)

8 DE Reg. 1697 (06/01/05)

19 DE Reg. 204 (09/01/15)

27 DE Reg. 620 (02/01/24)

3.0 Reciprocity

3.1 All reciprocity applicants must submit a copy of the state optometry licensing statutes and regulations for any jurisdiction through which they are seeking reciprocal licensure in Delaware.

3.2 "Standards of licensure," as used in 24 Del.C. §2109, means a state's qualifications for licensure and scope of practice.

3.3 An applicant's practice "for a minimum of 5 years" in another jurisdiction as used in 24 Del.C. §2109 means at least 200 hours of practice per year in that jurisdiction.

3.4 All reciprocity applicants must be CPR certified for both children and adults and maintain their certification while licensed.

4 DE Reg. 669 (10/01/00)

19 DE Reg. 204 (09/01/15)

27 DE Reg. 620 (02/01/24)

4.0 Continuing Education Requirements

4.1 Hours Required

4.1.1 Beginning in 2007, the required CE's shall be completed no later than June 30 of every odd-numbered year.

4.1.2 All non-therapeutically-licensed optometrists shall acquire 12 hours of continuing education (CE) during each biennial licensure period.

4.1.3 All therapeutically-licensed optometrists shall acquire 30 hours of continuing education during each biennial licensure period. Twenty of those 30 hours must be comprised of education in the areas of therapeutics and management of ocular disease. A maximum of 6 of the 30 may be in the area of practice management. All therapeutically-licensed optometrists must also maintain current CPR certifications for both children and adults throughout the licensure period.

4.1.4 Any new licensee shall be required to complete continuing education equivalent to 1 hour for each month between the date of licensure and the biennial renewal date. The first 12 hours of pro-rated continuing education must be in the treatment and management of ocular disease.

4.1.5 Hardship Exemption. The Board has the power to waive any part of the CE requirement. Exemptions to the CE requirement may be granted due to prolonged illness or other incapacity. Application for exemption shall be made in writing to the Board by the applicant for renewal and must be received by the Board prior to the end of the license renewal period.

4.2 Content of Mandatory Continuing Education (CE)

4.2.1 Six practice management hours will be accepted toward the continuing education requirement.

4.2.2 COPE-Approved Self-Reported Study

4.2.2.1 Non-therapeutically certified licensees. Of the 12 hour biennial requirement for non-therapeutically certified licensees, a maximum of 2 hours may be fulfilled by self-reported study.

4.2.2.2 Therapeutically certified licensees. Of the 30 hour biennial requirement for therapeutically certified licensees, a maximum of 6 hours may be fulfilled by self-reported study.

4.2.2.3 Self-reported study may include:

4.2.2.3.1 Reading of optometric journals

4.2.2.3.2 Optometric tape journals

4.2.2.3.3 Optometric audiovisual material

4.2.2.3.4 Other materials given prior approval by the Board

4.2.2.3.5 Proof of completion from the sponsoring agency is required for credit

4.2.3 Continuing Education courses given by the following organizations will receive credit. CE credit will be given for the scientific session portion only of any meetings of these organizations:

4.2.3.1 American Optometric Association

4.2.3.2 Delaware Optometric Association

4.2.3.3 American Academy of Optometry

4.2.3.4 Recognized state regional or national optometric societies

4.2.3.5 Schools and colleges of optometry

4.2.3.6 Meetings of other organizations as may be approved by the Board

4.2.3.7 COPE-approved courses

4.3 Failure to Comply with Continuing Education Requirements. Licensees who fail to comply with the required continuing education requirements by the end of the biennial licensing period may be referred for possible disciplinary action pursuant to 24 Del.C. §2113.

4.4 Proof of continuing education is satisfied with an attestation by the licensee that he or she has satisfied the requirements of Section 4.0. Licensees selected for random audit will be required to supplement the attestation with attendance verification pursuant to subsection 4.5.

4.5 Random audits will be performed by the Board to ensure compliance with the CE requirements.

4.5.1 The Board will notify licensees within 60 days after June 30 that they have been selected for audit.

4.5.2 Licensees selected for random audit shall be required to submit verification within 10 days of receipt of notification of selection for audit.

4.5.3 Verification shall include such information necessary for the Board to assess whether the course or other activity meets the CE requirements in Section 4.0, which may include the following information:

4.5.3.1 Proof of attendance. While course brochures may be used to verify contact hours, they are not considered to be acceptable proof for use of verification of course attendance;

4.5.3.2 Date of CE course;

4.5.3.3 Instructor of CE course;

4.5.3.4 Sponsor of CE course;

4.5.3.5 Title of CE course;

4.5.3.6 Number of hours of CE course; and

4.5.3.7 Report obtained from the Optometric Education (OE) tracker maintained by ARBO.

4.6 Licensees must maintain all proof of continuing education for at least 2 licensure periods.

4.7 Licensure--Renewal

4.7.1 The biennial licensure period expires on June 30 of every odd-numbered year. Licensees may renew their licenses by submitting a renewal application to the Board by the renewal date with the renewal fee prescribed by the Division of Professional Regulation and attestation of completion of the continuing education requirements.

4.7.2 Licensees who fail to renew their license by the renewal date may reactivate their license during the 1 year period immediately following the license expiration date provided the licensee pays a late fee in addition to the prescribed renewal fee, submits an application on an appropriate form to the Board and provides proof that they have completed the required continuing education.

10 DE Reg. 1727 (05/01/07)

19 DE Reg. 204 (09/01/15)

27 DE Reg. 620 (02/01/24)

5.0 Telehealth

5.1 Telehealth is the use of electronic communications to provide and deliver a host of health-related information and health-care services, including optometry-related information and services, over large and small distances. Telehealth encompasses a variety of health care and health promotion activities, including education, advice, reminders, interventions, and monitoring of interventions.

5.2 The Optometrist or Optometry Intern (referred to as "licensee" for the purpose of this regulation) who provides treatment through telehealth shall meet the following requirements:

5.2.1 Location of patient during treatment through telehealth

5.2.1.1 In order to practice telehealth in Delaware, optometrists must have an active Delaware license in good standing or have obtained an interstate telehealth registration in compliance with Title 24, Ch. 60.

5.2.1.2 Optometrists understand that this rule does not provide them with authority to practice telehealth in service to clients located in any jurisdiction other than Delaware, and they must comply with laws, rules, or policies for the practice of telehealth set forth by other jurisdictional boards of optometry.

5.2.1.3 Optometrists practicing telehealth shall comply with all of these rules of professional conduct and with requirements incurred in state and federal statutes relevant to the practice of optometry.

5.2.2 Informed consent

5.2.2.1 Before services are provided through telehealth, the optometrist shall obtain written, informed consent from the patient, or other appropriate person with authority to make health care treatment decisions for the patient. At minimum, the informed consent shall inform the patient and document acknowledgment of the risk and limitations of:

5.2.2.1.1 The use of electronic communications in the provision of care;

5.2.2.1.2 The potential breach of confidentiality, or inadvertent access, of protected health information using electronic communication in the provision of care; and

5.2.2.1.3 The potential disruption of electronic communication in the use of telehealth.

5.2.3 Confidentiality: The optometrist shall ensure that the electronic communication is secure to maintain confidentiality of the patient's medical information as required by the Health Insurance Portability and Accountability Act (HIPAA) and other applicable federal and state laws. Confidentiality shall be maintained through appropriate processes, practices and technology, including disposal of electronic equipment and data.

5.2.4 Competence and scope of practice

5.2.4.1 The optometrist shall be responsible for determining and documenting that telehealth is an appropriate level of care for the patient.

5.2.4.2 The optometrist shall comply with the Board's law and rules and regulations and all current standards of care requirements applicable to on-site care.

5.2.4.3 The optometrist shall limit the practice of telehealth to the area of competence in which proficiency has been gained through education, training, and experience.

5.2.4.4 All initial evaluations shall be performed face to face and not through telehealth or internet unless another Delaware-licensed optometrist or ophthalmologist is present at the originating site with the patient at the time of the diagnosis, or the provider meets the standard of service required by applicable professional societies in guidelines developed for establishing a health-care provider-patient relationship as part of an evidenced-based clinical practice in telemedicine.

5.2.4.5 The optometrist shall document in the file or record which services were provided by telehealth.

27 DE Reg. 620 (02/01/24)

6.0 Unprofessional Conduct

6.1 Optometrists who commit unprofessional conduct shall be subject to discipline.

6.2 Unprofessional conduct shall include but is not limited to the following:

6.2.1 Performing acts beyond the authorized scope of the level of optometric practice for which the individual is licensed.

6.2.2 Assuming duties and responsibilities within the practice of optometry without adequate preparation, or without maintenance of competency.

6.2.3 Performing new techniques or procedures without education and practice.

6.2.4 Inaccurately and willfully recording, falsifying or altering a patient or agency document record related to patient care, employment, or licensure.

6.2.5 Committing or threatening violence, verbal or physical abuse of patients or co-workers or the public.

6.2.6 Violating professional boundaries of the optometrist-patient relationship including physical, sexual, emotional or financial exploitation of the patient or patient’s significant other.

6.2.7 Assigning unlicensed persons to perform the practice of licensed optometrists.

6.2.8 Delegating optometric practice to unqualified persons.

6.2.9 Failing to supervise persons to whom optometric practice has been delegated.

6.2.10 Failing to safeguard a patient’s dignity and right to privacy in providing services.

6.2.11 Violating the confidentiality of information concerning a patient.

6.2.12 Failing to take appropriate action to safeguard a patient from incompetent or illegal health care practice.

6.2.13 Practicing optometry when unfit to perform procedures and make decisions in accordance with the license held because of physical or mental impairment or dependence on alcohol or drugs.

6.2.14 Diverting or misappropriating money, drugs, supplies, records or property of an employer, patient, patient agency, or governmental agency.

6.2.15 Practicing optometry with an expired license.

6.2.16 Allowing another person to use the optometrist’s license or temporary permit.

6.2.17 Aiding, abetting, or assisting an individual to violate or circumvent any law or duly promulgated rule and regulation intended to guide the conduct of an optometrist or other health care provider.

6.2.18 Committing fraud, misrepresentation or deceit in taking the licensure exam, or in obtaining a license or temporary permit.

6.2.19 Disclosing the contents of the licensing examination or soliciting, accepting or compiling information regarding the examination before, during or after its administration.

6.2.20 Failing to report unprofessional conduct by another licensee.

6.2.21 Practicing or holding oneself out as an optometrist without a current license.

6.2.22 Failing to comply with the requirements for continuing professional education, unless exempt.

6.2.23 Failing to take appropriate action or to follow policies and procedures in the practice situation designed to safeguard the patient.

6.2.24 Failing to comply with the terms and conditions set out in a disciplinary action of the Board.

6.2.25 Failing to honor a patient’s request to forward the patient’s complete prescription and ophthalmic or contact lens specifications to another licensed physician of medicine, osteopathy, optometrist, or a nationally registered contact lens technician working under the direct supervision of an optometrist, ophthalmologist or osteopathic physician, if all financial obligations to the licensee have been satisfied.

6.2.26 Prescribing contact lenses beyond 1 year from the date the contact lens prescription was finalized. For purposes of this section, a final prescription results when a patient is released to routine follow-up care.

6.2.27 Failing to maintain adequate records on each patient for a period of not less than 7 years from the date of the most recent service rendered.

6.2.28 Using unethical, misleading or unprofessional advertising methods, including baiting patients to purchase materials in exchange for free or reduced fees for professional services.

6.2.29 Practicing in a merchandising store or practicing optometry among the public as the agent, employee, or servant of, or in conjunction with, directly or indirectly, any merchandising firm, corporation, lay firm, or unlicensed individual.

6.2.30 Practicing in conjunction with, or as an agent or employee of, an ophthalmic merchandising business (commonly known as “opticians”), directly or indirectly.

6.2.31 Corporations, except those allowed under 8 Del.C. Ch. 6, lay firms, and unlicensed individuals are prohibited from the practice of optometry, directly or indirectly, and from employing, directly or indirectly, registered and licensed optometrists to examine the eyes of their patients. Licensees so employed will be considered guilty of unprofessional conduct and in violation of 24 Del.C. §2113(a)(3) and (6).

6.2.32 Holding oneself out as having superior qualifications or being superior to other optometrists, unless the optometrist is qualified by a specialty board approved by this Board.

6.2.33 No licensee holding an official position in any optometric organization shall use such position for advertising purposes or for self-promotion.

6.2.34 Being convicted of a crime substantially related to the practice of optometry.

19 DE Reg. 204 (09/01/15)

27 DE Reg. 620 (02/01/24)

7.0 Voluntary Treatment Option for Chemically Dependent or Impaired Professionals

7.1 If the report is received by the chairperson of the regulatory Board, that chairperson shall immediately notify the Director of Professional Regulation or his/her designate of the report. If the Director of Professional Regulation receives the report, he/she shall immediately notify the chairperson of the regulatory Board, or that chairperson's designate or designates.

7.2 The chairperson of the regulatory Board or that chairperson's designate or designates shall, within 7 days of receipt of the report, contact the individual in question and inform him/her in writing of the report, provide the individual written information describing the Voluntary Treatment Option, and give him/her the opportunity to enter the Voluntary Treatment Option.

7.3 In order for the individual to participate in the Voluntary Treatment Option, he/she shall agree to submit to a voluntary drug and alcohol screening and evaluation at a specified laboratory or health care facility. This initial evaluation and screen shall take place within 30 days following notification to the professional by the participating Board chairperson or that chairperson's designate(s).

7.4 A regulated professional with chemical dependency or impairment due to addiction to drugs or alcohol may enter into the Voluntary Treatment Option and continue to practice, subject to any limitations on practice the participating Board chairperson or that chairperson's designate or designates or the Director of the Division of Professional Regulation or his/her designate may, in consultation with the treating professional, deem necessary, only if such action will not endanger the public health, welfare or safety, and the regulated professional enters into an agreement with the Director of Professional Regulation or his/her designate and the chairperson of the participating Board or that chairperson's designate for a treatment plan and progresses satisfactorily in such treatment program and complies with all terms of that agreement. Treatment programs may be operated by professional Committees and Associations or other similar professional groups with the approval of the Director of Professional Regulation and the chairperson of the participating Board.

7.5 Failure to cooperate fully with the participating Board chairperson or that chairperson's designate or designates or the Director of the Division of Professional Regulation or his/her designate in regard to the Voluntary Treatment Option or to comply with their requests for evaluations and screens may disqualify the regulated professional from the provisions of the Voluntary Treatment Option, and the participating Board chairperson or that chairperson's designate or designates shall cause to be activated an immediate investigation and institution of disciplinary proceedings, if appropriate, as outlined in subsection 7.8 of this section.

7.6 The Voluntary Treatment Option may require a regulated professional to enter into an agreement which includes, but is not limited to, the following provisions: