in-20260304-IR-852250626SNA: UPDATES TO OPTOMETRY RULES

1. Comments received online:

Dr Brad Sutton - comments received online regarding 852 IAC 1-16-7 stating that removing “internet online CE” would nullify a lot of already approved CE courses. Response from the board is to put “internet online CE” back into the rule. Dr Brad Sutton - comments received online regarding 852 IAC 1-1.1-4 stating that this should not be a requirement of all licensees but only practitioners wanting to provide laser procedures/injections/minor lid surgery. Response from the board was to remove the language from 852 IAC 1-1.1-4 regarding “January 1, 2032, effective date” for certain examination requirements. Dr Nate Lighthizer - comments received online with concerns in the lack of multiple avenues to obtain certification to perform laser and surgical procedures in Indiana The board provided no additional response or changes to this comment. National Board of Examiners in Optometry (NBEO) - comments received online urging the board to consider the importance of including a national psychometrically validated examination as a required component of demonstrating competence. The board makes no additional changes to the proposed rule. Indiana Optometric Association (IOA) - comments online with concerns on 852 IAC 1-1.1-4 and 852 IAC 1-2.1-2, as they believe the proposed language is overly burdensome and regressive by requiring all applicants for licensure to pass all clinical skills that are not included in the NBEO part III exam The board's response was to remove the proposed language regarding January 1, 2032 effective date and requiring all applicants to take and pass additional exams that are not included in Part III Indiana Optometric Association (IOA) - provided comments online with concerns on 852 IAC 1-16-4 and requested the board to clarify its intent The board's response was to change the language from : (4) A board-approved method for verifying attendance will be implemented, such as physical attendance sheets or an electronic equivalent. It will now read: (4) A method for verifying attendance will be implemented, such as physical attendance sheets or an electronic equivalent. Indiana Optometric Association (IOA) - provided comments online with concerns on 852 IAC 1-16-3.5, and asks the board to provide clarity by adding language that exempts statutorily deemed providers The board made no changes to this section Indiana Optometric Association (IOA) - provided comments online with concerns on 852 IAC 1-16-7 and asked the board to provide clarity as to what constitutes a “deemed approved provider” The board's response indicated that this information is already located under 852 IAC 1-16-8 2. Comments received at the public hearing made by the below stating concerns with 852 IAC 1-1.1-4 and 852 IAC 1-2.1-2 (please see board's response at the end of the following comments) Dr Greg Norman - believes the proposed language is burdensome and costly by requiring all applicants for licensure to pass all clinical skills that are not included in the NBEO Part III exam as well as deter the younger public from wanting to practice Optometry. A lot of the students do not stay in Indiana to practice if they have no interest in lasers. Out-of-state practitioners do not want to obtain a license Indiana as they have no interest in lasers. He has concerns about NBEO being the only exam proctor. He provided statistics showing no adverse effects at all from veteran doctors who did not take the NBEO. Dr David Wilson - does not understand why people would be forced to take a test when they may not use that due to cost and may decrease the number of people that would come to Indiana to practice. Doesn't understand why the board only picks one certified body to provide the exam Dr Damon Dierker - states that it will have impact on student recruitment, a negative impact on patient access and the ability to attract talented optometrists to provide eye care for Hoosiers. At his facility, anyone providing these procedures has been through the Oklahoma course and/or an Accredited Ocular Disease Residency Dr Katie Connolly - feels this rule change will negatively impact the recruitment of Optometrist to practice in Indiana. Since this proposed rule she has seen a decline in students wanting to practice in Indiana. Dr James Stickel - states that the narrow definition as to which tests are acceptable in the proposed rule change will handcuff new applicants in the future with undue time, and cost burdens which will likely reduce the number of applicants for licensure in the state of Indiana Dr Darren Minnich - feels that mandating upcoming Optometrist to travel to North Carolina to take the LSPE is unwarranted and is unnecessary and the board should consider other proctoring to obtain laser certification. Dr Nicolas Garn - states that requiring NBEO Part III laser certification in order to obtain a license in the state of Indiana is not in the best interest of the profession or the patients they serve. The board's decision to add this to the rule could have unforeseen consequences with a potential decrease in interest in our state as a location for practice and cost. Donna James - this rule will deeply affect licensure in the state of Indiana. Adding additional testing adds another layer of complexity for new graduates. One being difficult to maintain during clinical rotation and preparing for parts II and III. The other would be the cost of having to travel to North Carolina. Dr Jeremy Gard - feels that it is overly restrictive and it will affect the future of the profession. Dr Jennifer Kohn - feels that this would create unnecessary barriers The board's response to the public comments above was to remove the proposed language from 852 IAC 1-1.1-4 and 852 IAC 1-2.1-2 as follows: (5) Beginning January 1, 2032, applicants for licensure shall provide an official NBEO Report of passing scores on all clinical skills examinations not included in NBEO's Part III Comments received at the public hearing made by the individuals below support the proposed rule and thus no response was necessary or taken by the board: REQUEST FOR PUBLIC COMMENT The board is soliciting public comment on the proposed rule. Comments may be submitted in one of the following ways: COMMENT PERIOD DEADLINE All comments must be postmarked or time stamped not later than April 3, 2026. The rule, Regulatory Analysis, appendices referenced in the Regulatory Analysis, and materials incorporated by reference (if applicable) are on file at the Professional Licensing Agency, Indiana Government Center South, 402 West Washington Street, Room W072, Indianapolis, Indiana and are available for public inspection. Copies of the rule, Regulatory Analysis, and appendices referenced in the Regulatory Analysis are available at the Professional Licensing Agency office. This notice is the second of two (2) thirty (30) day periods in which the public may comment on the proposed rule. Following this second public comment period, the board may adopt a version of the proposed rule that is the same as or does not substantially differ from the text of the proposed rule published in this notice. EXPLANATION OF DIFFERENCES IN PROPOSED RULE After the public hearing, the board reviewed 852 IAC 1-16-4 and updated the language under (4) per the IOA's request. Instead of reading: (4) A board-approved method for verifying attendance will be implemented, such as physical attendance sheets or an electronic equivalent, it will now read: (4) A method for verifying attendance will be implemented, such as physical attendance sheets or an electronic equivalent. They also updated 852 IAC 1-16-7 to add “(4) Internet Online” back into the rule. After board discussion they amended 852 IAC 1-1.1-4(a)(4) from “January 1, 2026” to “September 1, 2026”, amended 852 IAC 1-2.1-2(4) from “January 1, 2026” to “September 1, 2026”, amended 852 IAC 1-2.1-2(5) from “January 1, 2026” to “September 1, 2026”, amended 852 IAC 1-16-2(4)(A) from “January 1, 2026” to “September 1, 2026”, and amended 852 IAC 1-16-2(4)(B) from “January 1, 2026” to “February 1, 2026.” They also decided to remove the proposed language in 852 IAC 1-1.1-4(a)(5) and 852 IAC 1-2.1-2(6) regarding January 1, 2032, effective date for certain examination requirements. They also decided to remove the proposed language in 852 IAC 1-16-2(4) Accreditation Council on Optometric Education (ACOE). PROPOSED RULE 852 IAC 1-1.1-4 Applicant fees, transcripts, and examination scores for an optometry license Sec. 4. (a) Each An applicant for an optometry license shall submit the following: (b) The board adopts the procedures and standards of the ACOE for approval of schools of optometry and will only accept graduates of optometry schools accredited by the council as applicants for licensure, provided all other requirements are met. 852 IAC 1-2.1-2 Application file; contents Sec. 2. An applicant for an optometry license by endorsement shall submit the following: 852 IAC 1-16-2 Responsibilities of licensees Sec. 2. An optometrist must shall do the following: 852 IAC 1-16-3 Application for approval of synchronous in person continuing education sponsor Sec. 3. (a) "Synchronous in person" means the instructor is in the same room and face-to-face with the learner, even if other formats are used as audio-visual aids for teaching the course. (b) The sponsoring organization must shall file an application provided by the agency not later than thirty (30) days after the beginning date of the program. The application must contain the following information: (b) (c) As a condition to approval of programs, the sponsoring organization must shall agree to provide participants with a record of attendance. The record of attendance shall must state the following: (c) (d) The sponsor shall retain records of attendance by participants for three (3) years from the date of the program. (d) (e) The board may audit a sponsor's records or program to ensure compliance, quality, and the type of continuing education provided. 852 IAC 1-16-3.5 Synchronous virtual continuing education Sec. 3.5. Synchronous virtual continuing education, as defined by COPE and presented by a COPE approved instructor, that allows for real-time interaction between live instructors and learners, is approved for both optometry and legend drug credit hours if the following are met: 852 IAC 1-16-4 Standards for approval of optometry continuing education hours Sec. 4. (a) The board will approve a course if it determines that the course will make a significant contribution to the professional competency of optometrists who enroll. (b) In determining if a course meets this standard, the board will consider whether the following requirements are met: (c) Continuing education credit for interoffice, hospital, or surgery center observation of another practitioner in the provision of providing optometric or ophthalmological procedures, limited to eight (8) hours per biennial licensure period, may also be granted, subject to board approval. Submissions for continuing education credit must be submitted within thirty (30) days after the event and contain a sponsor-provided extensive outline and timeline of patients observed or participatory procedures. 852 IAC 1-16-4.1 Standards for approval of optometric legend drug continuing education hours Sec. 4.1. (a) The board will approve a course for optometric legend drug continuing education if it determines that the course will make a significant contribution to the professional competency of optometrists who enroll. (b) In determining if a course meets the requirements of this section, the board will consider whether the following requirements are met: (c) Courses that are approved by COPE in the areas of ocular pharmacology or ocular therapeutics with designations listed in subsection (d) are acceptable, and approval by the board is not required. Automatic approval of COPE approved courses will cease stop immediately upon notice from COPE that approval of the course has been discontinued for any reason. (d) Courses approved by COPE in the following areas are automatically approved for optometric legend drug or therapeutic continuing education: Sec. 7. (a) Self-study includes Asynchronous continuing education may include the following: (b) In order To be accepted as continuing education for an optometry license and optometric legend drug certificate renewal, self-study methods of presentation asynchronous continuing education must include passing a written examination or post evaluation, by a deemed approved provider, with a passing score of seventy percent (70%). (c) Self-study continuing education for an optometry license and optometric legend drug certificate renewal is limited to a total of ten (10) hours biennially. (c) Synchronous virtual continuing education combined with asynchronous continuing education may total not more than twelve (12) hours per biennial license renewal period of the total of forty (40) hours required for licensure and optometric legend drug certification. 852 IAC 1-17-1 Application file; contents Sec. 1. (a) An applicant for a limited license shall submit the following: (b) The dean at the Indiana University School of Optometry dean may be contacted in order to validate the suitability of the applicant for a limited license.