STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
FLORIDA MEDICAL ASSOCIATION, INC,. ) FLORIDA SOCIETY OF OPHTHALMOLOGY, ) and WILLIAM J. BROUSSARD, M.D., )
)
Petitioner, )
)
vs. ) CASE NO. 82-1886RX
)
DEPARTMENT OF PROFESSIONAL ) REGULATION, BOARD OF OPTOMETRY, )
)
Respondent. )
) FLORIDA OPTOMETRY ASSOCIATION, INC. ) JAMES A. STEPHENS, O.D., and )
DONNIE D. DANCE, O.D., )
)
Intervenors. )
)
)
FINAL ORDER
This case was heard by R. L. Caleen, Jr., Hearing Officer with the Division of Administrative Hearings, on October 24-28, and November 1, 1983, in Tallahassee, Florida.
APPEARANCES
For Petitioners: Kenneth G. Oertel, Esquire
Segundo J. Fernandez, Esquire Oertel & Hoffman, P.A.
646 Lewis State Bank Building Tallahassee, Florida 32301
For Respondent: Susan Tully, Esquire
Department of Legal Affairs Suite 1601, The Capitol Tallahassee, Florida 32301
For Intervenors: Leonard A. Carson, Esquire
Michael Parrish, Esquire Carson & Linn, P.A.
253 East Virginia Street Tallahassee, Florida 32301
ISSUES
Whether the State Hoard of Optometry's policy statement of November 8, 1975, which interprets Chapter 463, Florida Statues (1983)("F.S."), as allowing optometrists to Prescribe legend drugs, is an unpromulgated "rule" within the
meaning of Section 120.52(15), F.S., and therefore an invalid exercise of delegated legislative authority under Section 120.56, F.S. 1/
Whether the Board of Optometry's Proposed Rule 21Q-3.10, Florida Administrative Code ("F.A.C."), relating to the use and prescription of legend drugs by optometrists, lacks statutory authority and is therefore an invalid exercise of delegated legislative authority under Section 120.54(4)(a), F.S.;
Whether Proposed Rule 21Q-3.10 is invalid for failure to provide an adequate statement of economic impact, as required by Section 120.54(2)(c), F.S.
INTRODUCTION
On July 9, 1982, Florida Medical Association, Inc., Florida Society of Ophthalmology, and William J. Broussard ("petitioners"), together with others Subsequently dismissed, filed a rule challenge petition with the Division of Administrative Hearings challenging (1) the validity of a 1975 policy statement issued by the respondent Board of Optometry ("Board"), and (2) a proposed amendment to Rule 21Q-3.10, proposed for adoption by the Board on June 25, 1982.
On July 22, 1982, Florida Optometric Association, Inc., James A. Stephens and Donnie D. Dance ("intervenors") moved to intervene in this proceeding, alleging that their Substantial interests would be affected by the outcome.
Their motion, unopposed, was granted.
In July 1982, the Board of Optometry and intervenors moved to dismiss Petitioners for lack of Standing. The motions were granted, with leave to file an amended petition, which was subsequently filed on September 15, 1982. The Board and intervenors, moved, again, to dismiss for lack of standing, and, on November 24, 1982, the motions were granted and the amended petition was dismissed.
Petitioners appealed to the First District Court of Appeal and in February, 1983, the court--affirming in part and reversing in part--found the allegations, if true, sufficient to confer standing and remanded for further proceedings.
On remand, hearing was reset for October and November, 1983. The parties filed a prehearing stipulation and, at hearing, presented testimony by Dr. Tully Colcord Patrowicz, Dr. Edward Norton, Dr. Thomas Muther, Mildred Gardner, Edward
Walker, Seymore Rosen, Frederic B. Karl, William Wallace, Paul C. Ajamian, Linden Davidson, Rodney O. Horton, Howard Charles Lucas, James A. Stephens, Peter D. Liane, David James Gustafson, Joseph C. Toland, Roland W. Manthei, Louis J. Catania, Spurgeon B. Eure, John Isler, William E. Layden, William Joseph Broussard and Norman Edward Wallis. Petitioner's Exhibit Nos. 1-5, 7, 9, 12-14, 16-20, 25-28, 33, 42, 43, 47, 49, 50, and 52 were received into evidence, as were Respondent/Intervenors' Exhibit Nos. 1, 2A, 2B, 2C, 2D, 3, 4A, 5, 6A, 6B, 7A, 7B, 8, 9, 25-30, 35, 37-42, 44, 46, 52, 53A-C, 55, 55(1), 55(3), 55(4), 55(5), 55(6), 56(1) and 56(13). The transcript of hearing was filed on November 16, 1983, proposed findings of fact and conclusions of law on December 15, 1983.
Based on the evidence presented, the following facts are determined:
FINDINGS OF FACT
STANDING OF PARTIES
Petitioner FMA. Petitioner FLORIDA MEDICAL ASSOCIATION, INC. ("FMA"), a non-profit corporation, is organized and maintained for the benefit of the 13,500 Florida physicians who comprise its membership. The FMA acts on behalf of its members in matters of common importance. In addition to representing its members, FMA is committed to protecting, maintaining, and improving the quality of health care available to the public.
The stated nature and purpose of the FMA is to promote the science and art of medicine, and improve the public health.
Under its bylaws the FMA maintains a standing Council on Medical Services, which is primarily concerned with the delivery of medical services to the elderly and school children; to the impaired; and to recipients of public health service. One of the primary objectives of the Council is to Protect and enhance the delivery of health services in Florida to these health care recipients.
The FMA initiated this rule challenge on behalf of all its members to protect those interests within the purview of its organization.
Petitioner FSO. The FLORIDA SOCIETY OF OPHTHALMOLOGY, INC. ("FSO"), a non-profit corporation, is composed of members who are ophthalmologists-- physicians (M.D.'s) who specialize in diagnosing and treating eye disorders with drugs, surgery, and appliances such as corrective lenses and prisms. The practice of ophthalmology includes many types of eye care--from Sophisticated surgery techniques to prevent blindness to the more familiar eye examination. FSO acts, and is organized, to further the educational, political and professional interest of Florida ophthalmologists. The FSO is committed as an organization to protecting, maintaining and improving the quality of eye care available to the public.
The FSO's membership includes over 400 of the approximately 550 ophthalmologists practicing in Florida. Many members of the FSO are also members of the FMA. The FSO initiated this rule challenge on behalf of itself and its members.
Petitioner Broussard. WILLIAM J. BROUSSARD, M.D., is a licensed Florida physician. Since 1967, he has been a resident of Broward County, Florida, and has engaged in the practice of medicine, specializing in ophthalmology.
He and the other physician members of petitioners FMA and FSO hold licenses to practice medicine issued under the authority of Chapter 458, F.S.
Unauthorized Practice of Medicine. Under Chapter 458, F.S. other health care professionals are prohibited from practicing medicine unless within the confines of their organic act, which, in the case of optometrists, is Chapter 463, F.S. If Optometrists are not authorized by Chapter 463 to prescribe and use legend drugs in their practice, the prescription and use of such drugs could constitute an unlawful encroachment on the practice of medicine. Moreover, physicians, especially ophthalmologists, would suffer economic injury since it is likely that Some patients who would have otherwise Sought their services would, instead, seek the services of optometrists.
5 Respondent Board of Optometry. Respondent STATE OF FLORIDA, DEPARTMENT OF PROFESSIONAL REGULATION, BOARD OF OPTOMETRY, ("BOARD") is a state agency within the meaning of Section 120.52(1), F.S.
Intervenor Florida Optometric Association, Inc. FLORIDA OPTOMETRIC ASSOCIATION, INC., ("FOA") is an incorporated organization of approximately 700 licensed optometrists in Florida. Its purpose is to promote and protect the interests of optometrists and the public by ensuring the availability of quality optometric service at reasonable prices. It represents its membership by participating in administrative, judicial, and legislative proceedings.
Intervenor James A. Stephens, O.D. Dr. Stephens is a licensed optometrist in Quincy, Florida, who uses drugs in his practice.
Intervenor Donnie D. Dance, O.D. Dr. Dance is a licensed optometrist in Ft. Myers, Florida, who uses drugs in his practice.
Intervenors FOA, Stephens, and Dance. These intervenors have been, and will be, substantially affected by the challenged policy statement and rule, which regulate, and implicitly authorize, the prescription and use of legend drugs by optometrists in their practice.
THE CHALLENGED POLICY STATEMENT AND PROPOSED RULE
The 1975 Policy Statement. At various workshops held in 1975, the BOARD discussed adopting a rule on the use of drugs by optometrists in their practice. It asked its attorney to draft a rule on the subject. He submitted, instead, a written policy statement on the use of drugs in optometry, which the BOARD adopted at its November 8, 1975, meeting. On November 12, 1975, the statement was disseminated to all licensed optometrists in Florida. It was transmitted by a BOARD cover letter:
To All Licensed Optometrists:
On November 8, 1975, the Florida State Board of Optometry adopted a policy statement on the use of drugs in optometry. A copy is enclosed.
This statement is important. It should be carefully read and then retained for future reference and review.
Questions should be submitted to the Board in writing. (Emphasis in original)
(Petitioner's Exhibit No. 2)
This BOARD policy statement concluded, among other things, that there was "no specific or absolute prohibition" of the use of drugs by optometrists; that the need for health care services was so great that no action should be taken to restrict such services unless necessary to protect the public from injury; and that the education requirements of optometrists had been raised so that they had become at least as well educated in pharmacology as other health care professionals, whose right to use drugs in their practice had not been questioned.
By this Policy statement, the BOARD, without citing or relying on any specific language in the statute, announced its interpretation that Chapter 463, F.S. (1975) allowed optometrists to use drugs in the practice of optometry. It cautioned optometrists, however, not to practice beyond their level of individual competency. Although not expressly stated, the policy statement was referring to the use of legend drugs--that is, drugs which were required by federal or state law to be dispensed only on prescription.
This policy statement was never adopted as a rule in accordance with the rulemaking procedures of Section 120.54, F.S. (1975). It has never been rescinded or changed by the BOARD--and has been in effect since 1975.
This written policy statement effectively notified all licensed optometrists in Florida that they were authorized to use legend drugs in the practice of optometry, provided they were individually competent to do so. This was the purpose of the statement, and this was its effect. Optometrists relied on this statement as authority for the use of legend drugs in their practice.
The Proposed Rule: 21Q-3.10. On June 25, 1982, the BOARD, published notice of its intent to adopt an amendment to Rule 21Q-3.10, F.A.C., setting standards for the prescribing and use of legend drugs by optometrists and providing guidelines for determining the competence of individual optometrists who use such drugs. A public hearing on the proposed rule was held on July 22 and 23, 1982. Transcripts and exhibits presented during the previous rulemaking workshops were received into the record, and no witnesses were presented by either petitioners or intervenors. As a result of the hearing, the BOARD made several changes to the proposed rule. Notice of these changes was published in the Florida Administrative Weekly and the proposed rule (with changes) was filed for adoption on November 30, 1982. (Respondent/Intervenors' Exhibit No. 1)
The proposed rule warns optometrists against performing treatment which they are not competent to perform; requires optometrists diagnosing angle closure, infantile, or congenital forms of glaucoma to refer such patients to a physician; requires optometrists treating an eye condition with steroids to refer such patients to a physician when the condition does not improve; requires BOARD approval prior to employing 10 percent phenylepherine hydrochloride, which approval will be granted only after training in life-sustaining emergency medical procedures; requires consultation with a physician when, in the optometrist's judgment, an infectious corneal disease has not responded to treatment; authorizes optometrists to employ non-controlled oral analgesics for relief of severe pain associated with eye trauma, for up to 48 hours, and for longer periods after consulting with a physician; defines legend drugs as substances required by federal or state law to be dispensed only on prescription, and excludes controlled substances defined by Chapter 893, F.S.; and establishes qualifications (consisting of completion of specified course work and clinical training in designated subject areas) which create a rebuttable presumption that an optometrist is competent to prescribe legend drugs in the practice of optometry. (Respondent/Intervenors' Exhibit No. 1(r)).
The proposed rule is premised on the BOARD's long-standing interpretation that Chapter 463, F.S. authorizes optometrists to use legend drugs to diagnose and treat eye disorders, including diseases and injuries. The rule attempts to narrow or refine that authority by providing standards for employing and prescribing legend drugs, and by providing guidelines for determining the competence of individual optometrists to prescribe and use such drugs.
The proposed rule contains definite and objective standards. Petitioners have not substantiated their allegation that the rule is unduly vague.
The economic impact statement which accompanies the proposed rule addresses, in detailed fashion, each factor listed in Section 120.54(2)(a), F.S. The statement assumes that Chapter 463 does not prohibit the use of legend drugs by optometrists and that the use of legend drugs by optometrists has become a pattern of practice in Florida.
OPTOMETRY: ORIGIN, SCOPE OF PRACTICE, AND TECHNICAL TERMS
Origin. The profession of Optometry Originated in the late 1800's when some opticians--who were qualified to fill prescriptions for glasses, fit frames, and grind lenses--assumed the additional function of refraction. Up to that time refraction had been the exclusive responsibility of physicians. (Refraction consists of measuring the ability of the eye to refract or bend light rays entering it so as to form an image on the retina.) These refracting opticians became known as optometrists. In the early 1900's most states, including Florida, passed laws defining optometry and expressly authorizing optometrists to examine eyes for refractive error.
Dictionary and Commonly Understood Definition of Optometry. Since the early 1900's, optometry has been commonly understood, and defined in dictionaries, as excluding the use of drugs or surgery. Webster's New Collegiate Dictionary (1981) at 799, defines optometry as:
the art or profession of examining the eye for defects and faults of
refraction and prescribing correctional lenses or exercises but not drugs or surgery.
Professional Definition of the Scope of Optometry. During the 1940's and 50's, optometry was viewed as the art and science of visual care. Optometrists did not view their profession as embracing the use of drugs. In 1945, the American Optometric Association approved the following occupational definition:
"OPTOMETRISTS (profess & kin) 0-53.10. Examines eyes, determines their con- dition, and prescribes treatment to conserve or improve vision without use
of medicine, drugs or surgery; determines visual difficulties (refracts) by means of instruments such as ophthalmometer skiascope, and ophthalmoscope; refers patients having ocular manifestations
of disease to a medical practitioner; prescribes lenses, prisms, or visual training as necessary to correct or improve vision; tests finished lenses to insure conformance to prescriptions,
using lens testing machines. May Specialize in a particular phase of optometry such as prescribing and fitting contact lenses and telescopic spectacles or surveying and
correcting visual deficiencies among industrial workers." (e.s.)
(Petitioners' Exhibit No. 52, page 329)
In 1967, Congress was considering a bill which would have amended a District of Columbia law to include within the definition of optometry, "the employment of any . . . means for the examination of the human eye." H.R. 12276, 90th Congress, 1st Session, Section 3(2)(1967). Dr. Judd Chapman, a Florida optometrist serving as Chairman for Legislation of the American Optometric AsSociation, testified about the amendment before a congressional subcommittee. When asked if this proposed language would authorize optometrists to use drugs, he replied:
No, sir, it does not . . . in fact that language is in a great number of the statutes defining optometry throughout the nation. That is very common . . . No, sir, that does not include the use of drugs.
(Petitioners' Exhibit No. 43)
Optometrists did not view their profession as including the diagnosing and treating of eye injury or eye disease. The treating of eye disease normally required use of drugs or surgery. When optometrists detected eye disease, or ocular manifestation of systemic disease (or pathology) they referred the patient to a qualified physician.
Scope of Optometry as Defined by Florida Law. Since 1939, Florida's statutory definition of optometry (and its scope of Practice) has remained relatively unchanged. 2/ Section 463.002(4), F.S. provides:
"Optometry" means the diagnosis of the human eye and its appendages; the employment of any objective or subjective means or methods for the
purpose of determining the refractive powers of the human eyes, or any visual, muscular, neurological, or anatomic anomalies of the human eyes and their appendages; and the prescribing and employment of lenses, prisms, frames, mountings, contact lenses, orthoptic exercises, light frequencies, and any other means or methods for the correction, remedy, or relief of any insufficiencies or abnormal conditions of the human
eyes and their appendages.
The BOARD asserts that this statutory definition is broad enough to authorize adoption of the proposed rule regulating (and permitting) the use of legend drugs by optometrists. The question of whether Chapter 463, generally, and this definition of optometry, in particular, authorize optometrists to use drugs in their practice has been asked before with varying, and sometimes conflicting answers.
Florida Attorney Generals' opinions have answered this question differently. In 1957, AGO 057-79, concluded that:
The practice of optometry, as defined by Section 463.01, F.S., and cases from other jurisdictions obviously does not authorize optometrists to administer drugs, or perform surgery in the diagnosis of, or treatment of
the refractive powers of the human eye. Therefore, question 1 [is an optometrist permitted to administer drugs and perform surgery?] is answered in the negative. (e.s.)
In 1959, AGO 059-24, addressed whether an eye care publication was misleading advertising. The Attorney General, citing Section 463.01 (defining the practice of optometry) stated:
In view of the foregoing definitions of optometry, it appears that the treatment of ocular diseases is not
a part of the practice of optometry;
* * *
It further appears by the statutes and possibly from the professional definition that an optometrist is restricted to diagnosing the things mentioned in Section 463.01, Florida Statutes, and
not diseases. (e.s.)
What was obvious to one Attorney General in 1957, was less obvious to another in 1975, who was asked this question by the attorney for the BOARD:
Does Chapter 463, F.S., prohibit licensed optometrists from utilizing drugs within the scope of the practice of optometry as defined by Section 463.01, F.S.?
The Attorney General, by letter dated December 22, 1975 (an unpublished Attorney General`s opinion), answered this question in the negative, ice. Chapter 463 does not forbid the use of drugs by optometrists.
Various Florida Boards of Optometry have also answered this question differently. Although the 1975 Board (which adopted the challenged policy statement) and the present Board (which proposed the challenged rule) both agree--without citing specific language Chapter 463 authorizes optometrists to use legend drugs, an earlier 1962 Board of Optometry was less certain. In June, 1962, that Board adopted a rule prohibiting the use of drugs except under certain circumstances:
250-1.32. Use of Drugs Prohibited Except Under Certain Circumstances
In the practice of optometry as defined in Section 463.01, Florida Statutes,
a registered optometrist in this state
is prohibited from using or prescribing drugs in connection with the treatment of pathological conditions of the eye or any of its appendages, provided, however, that drugs may be used and
prescribed in connection with the fitting of contact lenses and examinations
for purpose of testing or diagnosis
of the eyes but not for treatment thereof.
Three months later, the Board repealed this rule, explaining: [T]his existing Rule 250-1.32 was
repealed by the Board because it
was felt that the rule was probably beyond the power of the Board to promulgate inasmuch as the law itself,
Chapter 463, Florida Statutes, made no mention of drugs in its definition of the practice of optometry.
(Petitioners' Exhibit No. 16)
Unsuccessful Legislative Efforts to Resolve the Question. In 1974, two bills were introduced in the Florida Legislature which would have expressly prohibited the prescription and use of legend drugs by optometrists. Both bills were defeated. (Respondent's Intervenors Exhibit No. 5) In 1975, the legislature created a commission to study the use of drugs by Optometrists and make recommendations to the 1975 legislature. Ch. 75-239, Laws of Florida (1975). This commission composed of 4 legislators, 2 optometrists and 2 opathalmogists studied the question and, on January 5, 1976, recommended that the legislature take no action:
The Commission recommends that legislative action on this issue of the appropriateness of the use of drugs by Optometrists is not warranted at the present time.
This recommendation should not be construed as an endorsement of the prescribing of,
or use of, drugs by optometrists but re- flects an agreement on the part of members of the Commission that this issue is of a professional nature and would best be resolved through cooperative discussions between the respective Boards and Societies of the Optometrists and Ophthalmologists.
(Respondent's Exhibit No. 2(c); 6(a), (b).)
In 1981 and 1982, bills were introduced which would have expressly allowed Optometrists to use legend drugs under specified conditions. Those bills were also defeated.
In 1983, the legislature passed Senate Bill 168, which would have allowed Optometrists to use legend drugs. It was vetoed by the Governor and never became law.
The Use of Legend Drugs by Optometrists. Some Florida optometrists have been using legend drugs for diagnostic and therapeutic purposes. Since the Florida Board of Pharmacy does not permit pharmacists to honor their prescriptions optometrists have to obtain their drugs from other Sources. Most of the drugs they have used are intended for topical application to the eye. Generally, they are classified as topical anesthetics, mydriatics, cycloplegics, miotics, and antibiotics.
Topical anesthetics ease discomfort when tonometry is used to measure intraocular pressure of the eyes--a test for glaucoma.
Mydriatics dilate the pupil so that the examiner can view the interior of the eye with an ophthalmoscope or slit lamp.
Cyclopegics cause paralysis of accomodation and facilitate refractions in children.
Miotics constrict the pupil after it has been dilated with mydriatics.
Antibiotics are used mainly to treat conjunctivitis
Although these drugs may be helpful, they are not essential to examining or refracting human eyes.
These drugs have known side effects which, although rare, may be quite severe.
Technical Meaning of Statutory Terms. As stated earlier, Section 463.002(4), F.S., contains the legislative definition of optometry:
"Optometry" means the diagnosis of the human eye and its appendages; the employment of any objective or subjective means or methods for the
purpose of determining the refractive powers of the human eyes, or any visual, muscular, neurological, or anatomic anomalies of the human eyes and their appendages; and the prescribing and employment of lenses, prisms, frames, mountings, contact lenses, orthoptic exercises, light frequencies, and any other means or methods for the correction, remedy, or relief of any insufficiencies or abnormal conditions of the human
eyes and their appendages. (e.s.)
This definition contains terms and phrases which have assumed commonly understood, or technical, meanings among optometrists and ophthalmologists:
"Diagnosis of the human eye," means identification of the organ and its function as an optical instrument. It does not mean "diagnosis of diseases of the human eye," a function involving the medical process of differential diagnosis, whereby all other possible diseases are eliminated--one by one--until only the suspected disease remains.
"Objective . . . means . . . for . . . determining the refractive powers of the human eyes," means the use of instruments for measuring visual acuity. "Subjective means . . . for . . . determining the refractive powers" means the placing of various lenses in front of a patient's eyes and asking how the lenses affect the patient's sight.
"Anomalies" of the human eyes includes developmental or functional defects, not diseases--which are caused by pathological processes.
The latter part of this statutory definition lists specific modalities of treatment which may be prescribed or employed by optometrists, including "lenses, prisms, frames, mountings, contact lenses, orthoptic exercises [and] light frequencies." These constitute a class of items which are prosthetic devices, or appliances, and exercises. Their common characteristics are that they are neither invasive nor intrusive; and they do not operate at the level of cell physiology. Neither do they exhaust the class. Lid crutches (which are mounted in the frame and tend to hold a lid open) and eye patches (which prevent the light image from falling on the retina) are examples of items omitted from the list.
In the language of optometrists and ophthalmologists these optic appliances are "prescribed" for a patient.
These specifically listed appliances or exercises have a common purpose: to correct refractive error. This occurs when there is nothing basically wrong with the eye, except it is too big, or overpowered, or underpowered, and images are distorted.
"Prisms" and "lenses" are mounted into the eyeglass frame. A "mounting" refers to propping glasses on the nose and hanging them from the ears. "Contact lenses" are mounted on the eye's surface and, like eyeglasses, weaken or strengthen the eye--as needed--to cause the image to fall onto the retina.
CONCLUSIONS OF LAW I.
Jurisdiction. The Division of Administrative Hearings has jurisdiction over the parties and subject matter of this Proceeding. 120.54(4), 120.56, F.S.
Standing. Petitioner's have standing to challenge--as do intervenors to defend--the validity of the 1975 policy statement and the recently proposed amendment to Rule 21Q-3.10, F.A.C. These parties are, or will be, substantially affected within the meaning of Sections 120.54(4)(a) and 120.56(1), F.S. See, Florida Medical Association, Inc. et al. v. Department of Professional Regulation Board of Optometry, et al., 426 So.2d 1112 (Fla. 1st DCA 1983).
Constraints on Agency Rulemaking. Agencies are creatures of statute and have no inherent authority. 120.54(14), P.S. Their powers are limited to those expressly granted or necessarily implied by statute. See, 4 Jur. 2d, Administrative Law 46. When the legislature delegates rulemaking power to administrative agencies, such power is limited and circumscribed by the statute conferring it. State v. Atlantic Coastline R. Co., 47 So. 969 (Fla. 1908). No agency can adopt a rule which amends, adds to, or conflicts with a statute.
Seitz v. Duval County School Board, 366 So.2d 119, 121 (Fla. 1st DCA 1979), cert. den. 375 So.2d 911; State Department of Health and Rehabilitative Services
v. McTigue, 387 So.2d 454 (Fla. 1st DCA 1980); Department of Health and Rehabilitative Services v. Florida Psychiatric Society, Inc., 382 So.2d 1280, 1285 (Fla. 1st DCA 1980). No agency can adopt rules which exceed its delegated power or are contrary to the intent of the legislature. See, Dept. of Citrus v. Office of Comptroller 416 So.2d 820 (Fla. 2d DCA 1982). Any rule which attempts to do so is an invalid exercise of delegated legislative authority. If there is reasonable doubt about the existence of a power being exercised by an agency, the further exercise of that power should be arrested. Atlantic Coastline R. Co., supra Edgerton v. International Co., 89 So.2d 488, 489-90 (Fla. 1956); State ex rel. Greenberg v. State Board of Dentistry, 297 So.2d 628, 636 (Fla. 1st DCA 1974).
Position of Petitioners. In the instant case, petitioners contend that the BOARD'S policy statement and proposed rule regulate, and implicitly authorize, the use of legend drugs by optometrists in their practice; that the BOARD lacks statutory authority to regulate or authorize the use of such drugs by optometrists; and that the use of such drugs to diagnose and treat eye conditions constitutes the unauthorized practice of medicine. Further, they contend that the economic impact statement is inadequate because it mistakenly assumes that optometrists may lawfully prescribe and use legend drugs in their practice, and that there is an existing pattern of such practice; and that the 1975 policy statement on the use of drugs is invalid because it is, in effect, a rule but was not adopted as such in accordance with the rulemaking procedures of Chapter 120, F.S.
Position of Board of Optometry and Intervenors. The Board of Optometry and the intervenors argue, among other things, that the BOARD has authority to adopt the rule; that it is authorized to do so by the plain wording of Chapter 463; that, subject to the rule, optometrists are qualified by training and education to safely prescribe and use legend drugs in diagnosing and treating eye disorders, including refractive error and pathological diseases; that the rule contains standards of practice for optometrists and simply refines the statutory definition of the scope of optometry; that the use of legend drugs by optometrists is useful and necessary; that the statute should be construed to allow Optometrists to use any means or methods taught by the various schools of optometry and recognized by the BOARD; and that deference should be granted the BOARD's interpretation of the statute in its charge. Further, they argue that the 1975 policy statement is not a rule" because it was not intended to create rights, require compliance, or otherwise have the direct and consistent effect of law.
II.
For the reasons which follow, it is concluded that the proposed rule lacks statutory authority and is an invalid exercise of delegated legislative authority. It is also concluded that the BOARD's 1975 policy statement on the use of drugs is a "rule," as defined by Chapter 120, F.S., but was not adopted as such in accordance with prescribed rule-making procedures. It too is, therefore, an invalid exercise of delegated legislative authority.
Legislative Intent and Ambiguous Statutory Language. Legislative intent is the essence of the law. State v. Sullivan, 116 So.255 (Fla. 1928). The cardinal rule of statutory construction is that "a statute should be construed so as to ascertain and give effect to the intention of the legislature as expressed in the statute." Deltona Corp. v. Florida Pub. Serv. Comm'n., 220
So.2d 905, 907 (Fla. 1969). When a statute is plain and unambiguous, there is no room for construction the plain meaning need only be given effect. State v. Egan, 287 So.2d 1, 49 (Fla. 1973).
But Chapter 463 and Section 463.002(4), in particular, do not express legislative intent in plain and unambiguous terms. The statute does not expressly authorize or prohibit the prescription and use of legend drugs by optometrists. The question is whether this statute may be permissibly interpreted as authorizing optometrists to use legend drugs.
When a statute is ambiguous, as is the case here, various rules of statutory construction may be used to ascertain legislative intent. Statutes are considered to have been enacted with knowledge that they would be interpreted in accordance with these rules. 73 Am. Jur. 2d, Statutes, 142. The legislative history or evolution, of a statute may be material. Blount v. State, 138 So.2d 2 (Fla. 1931). Ordinarily, the statute should be given the meaning assigned to it at the time it was enacted. State v. JackSonville, 50 So.2d 532 (Fla. 1951)
Statutory History and Meaning Assigned at Time of Enactment. The first statute regulating the practice of optometry in Florida was adopted in 1909, and defined the practice of optometry as:
The use or employment of tests or examinations for the determination of the natural and functional deficiencies of the eye and the
adaption of lenses for the aid thereof.
1 Ch. 5947, Laws of Florida (1909). Physicians were expressly exempted from the law regulating optometrists and have always been authorized to provide services included within the scope of optometry.
In 1921, the legislature expanded the definition of optometry and expressly prohibited the use of drugs, medicine, or surgery:
The practice of optometry for the purposes of the Act is hereby defined as being either one or any combination or part of the following:
The examination of the human eye, without the use of drugs, medicine,
or surgery, to ascertain the presence of defects or abnormal conditions which may be corrected, remedied or relieved or the effects of which may be corrected, remedied or relieved
by the use of lenses or prisms.
The employment of subjective or objective mechanical means without the use of drugs, medicine or surgery to determine the accommodative or refractive conditions, or the range of powers of vision, or muscular equilibrium of the human eye.
The adaptation or the adjustment of lenses or prisms without the use of drugs,
medicine or surgery to correct, relieve
or remedy any defect or abnormal condition, or to correct, relieve or remedy the effects of any defect or abnormal con- dition of the human eye or to adjust the human eye to the conditions of a special occupation.
The adaptation or adjustment of lenses or prisms, without the use of drugs, medicine or surgery, in any manner to
the human eye for any purpose, either directly or indirectly. (e.s.)
1 Ch. 8580, Laws of Florida (1921).
In 1931, the definition of optometry was amended again. The prohibition on use of drugs or surgery in refracting human eyes was retained, but it was deleted in connection with the prescribing and employment of lenses, prisms, and ocular exercises:
That the practice of Optometry, for the purposes of this Act, is hereby defined as follows, viz.: to be the employment of any objective or subjective means or methods without drugs or surgery for the purpose of determining the refractive powers
of the human eyes, or any visual or muscular anomalies of the human eye
and its appendages, and the prescribing and the employment of lenses, prisms, ocular exercises for the correction, remedy, or relief of any insufficiencies or abnormal conditions of the same;
an optometrist is one who practices Optometry in accordance with the provisions of this Act. (e.s.)
This deletion of the earlier prohibition did not, however, authorize optometrists to use drugs (or any other form of treatment) not mentioned in the statute. Under the rule, expression unius est exclusio alterius, the listing of specific modes of treatment effectively excluded all others. Dobbs v. Sea Isle Hotel, 56 So.2d 341, 342 (Fla. 1952).
It was in 1939 that the legislature revised, once more, the definition of optometry (1) by removing the remaining prohibition against using drugs to determine refractive powers and (2) by adding a general description, "and any other means or methods," after the specifically listed modes of treatment:
That the practice of Optometry is hereby declared a profession, and for the purpose of this Act, is hereby defined as follows, viz: to be the diagnosis of the human eye and its appendages, and the employment of any objective or subjective means or methods for the
purpose of determining the refractive powers of the human eyes, or any visual, muscular, neurological or anatomic anomalies of the human eyes and their appendages, and the pre- scribing and employment of lenses, prisms, frames, mountings, orthoptic exercises, light frequencies and any
other means or methods for the correction, remedy, or relief of any insufficiencies or abnormal conditions of the human eyes and their appendages, and an Optometrist is one who practices Optometry in accordance with provisions of this Act. (e.s.)
1 Ch. 19031, Laws of Florida (1939)
The question then becomes whether, by these two changes, the 1939 Legislature intended to authorize optometrists to use and prescribe legend drugs in the practice of optometry, including the treating of eye injury and disease. A law cannot be interpreted to encompass a situation not within its purview at the time of its enactment. Radio Telephone Communications, Inc. v. Southeastern Telephone Company, 170 So.2d 577 (Fla. 1964).
Although statutory language may appear to have a clear meaning, it may not be assigned a meaning which is inconsistent with other statutes in pari materia. See, 30 Fla. Jur., Statutes 101. A construction which places related statutes in conflict should be avoided. Howarth v. City of Deland, 158 So.294 (Fla. 1934;
From 1921 to the present, the Medical Practice Act, now Chapter 458, F.S., has exempted those perSons from its coverage who, without the use of drugs, fit lenses or other appliances or examined eyes for such purposes:
Definition of Practice of Medicine; Exceptions--
* * *
This Chapter [the Medical Practice Act] shall not be construed to affect any person or manufacturer who without the use of drugs or medicines mechanically fits or sells lenses, artificial eyes, limbs or other
apparatus or appliances, or is engaged in the mechanical examination of eyes for the purpose of constructing or adjusting spectacles, eyeglasses or lenses; (e.s.)
458.13, F.S. (1941). See also, 14 Ch. 8415, Laws of Florida, (1921); 458.3031(1)(h), F.S. In 1939, this was the only exemption in the Medical Practice Act which protected optometrists--who were not exempted by name--from charges of engaging in the unauthorized practice of medicine. Yet this provision applied only to persons who examined eyes and fit lenses without the use of drugs.
It follows that the 1939 legislature could not have intended that its removal of a prohibition against the use of drugs be interpreted as authorizing their use. Such a construction would have placed the Optometric Practice Act and the Medical Practice Act in direct conflict--and placed optometrists in an untenable position. They would have been authorized by the Optometric Practice Act to use drugs to examine eyes or fit lenses; but as soon as they did so, they would be in violation of the Medical Practice Act and subject to charges of unauthorized practice of medicine since such acts--beyond the exemption constitute the practice of medicine. See, 458.13, F.S. (1941). It is concluded, therefore, that the 1939 legislature did not intend that its deletion of a prohibition equate to an authorization. Since the definition of optometry has not significantly changed since 1939, the legislative intent at the time of enactment must be given effect. This conclusion that the legislature did not intend to authorize optometrists to use drugs is reinforced by application of the rule of ejusdem generis to that part of the definition which describes the forms of treatment which optometrists may render.
The Rule of Ejusdem Generis. In ex parte Amos, 112 So.289 at 293 (Fla. 1927), the Florida Supreme Court recognized this as a controlling rule of statutory construction. It means:
"Where an author makes use first of terms each evidently confined and limited to a particular class of a known species of things, and
then after such specific enumeration subjoins a term of very extensive signification, this term, however general and comprehensive in its possible import, yet when thus
used embraces only things ejusdem generis; that is, of the same
kind of species with those comprehended by the preceding limited and confined terms."
The maxim is a more specific application of the broader maxim "noscitur a sociis," which means that general and specific words which are capable of an analogous meaning being associated together take color from each other, so that the general words are restricted to a sense analogous to the less general. [Cases omitted]
Id. The rule aids in the construction of a statute which enumerates specific items of a class, which is not exhausted by the enumeration, and which concludes the series with a general term descriptive of the class. State v. Town of Davie, 127 So.2d 671, 673 (Fla. 1961)
Here, that portion of the statutory definition which describes forms of treatment which may be used in optometry provides:
"Optometry" means . . . the prescribing and employment of lenses, prisms, frames, mountings, contact lenses, orthoptic
exercises, light frequencies, and any other means or methods for the correction, remedy, or relief of any sufficiencies or
abnormal conditions of the human eyes and their appendages. (e.s.)
463.002(4), F.S. The rule of ejusdem generis applies, since the enumerated forms of treatment constitute a class not exhausted by the enumeration. The general description (which follows the series), "any other means or methods," must, therefore, be construed as meaning forms of treatment of the same kind or species as those enumerated. See, Hanna Sunrise Recreation, Inc. 94 So.2d 597 (Fla. 1957). Legend drugs, which can be invasive or intrusive, operate at the cellular level and are not of the same kind or species as the enumerated forms of treatment. The use of legend drugs by optometrists to correct, remedy, or relieve any insufficiencies or abnormal conditions of the eyes exceeds the scope of optometry, as defined by Florida law. The proposed
rule implicitly authorizes such use and is, therefore, invalid.
If the Legislature Intended to Authorize Optometrists to Prescribe and Use Legend Drugs in the Practice of Optometry It Would Have Expressly Stated It. If the 1939 legislature had intended to authorize optometrists to, prescribe and use legend drugs--something it never before permitted--it would have expressed this intent in clear and unmistakable terms. In 1939, the granting of such power to optometrists would have been a complete reversal of prior legislative policy and would have greatly expanded the scope of optometry in Florida. Such an expansion would have been inconsistent with the definition and scope of optometry as commonly understood, and as understood by optometrists themselves. Furthermore, the 1939 amendment uses language which, among optometrists and ophthalmologists, conveys specific meaning. Assigned this meaning, the 1939 amendment (redefining the scope of optometry) does not expressly, or by reasonable inference, authorize optometrists to prescribe or use legend drugs in the practice of optometry.
Authorization to Prescribe and Use Legend Drugs Must be Affirmatively Granted by Statute, Not Agency Rule. Section 458.305(3), F.S., part of the Medical Practice Act, defines the "practice of medicine" in broad and all- encompassing terms. Recognizing the reach of this definition, the legislature specifically exempted from the Medical Practice Act:
Other duly licensed health care practitioners acting within their scope of practice authorized by statute. (e.s.)
458.303(1)(a), F.S. so to the extent other health care practitioners, such as optometrists engage in acts that would fall within the broad definition of "practice of medicine," such persons will not be in violation of Chapter 458 (and subject to unauthorized practice of medicine charges) as long as their acts fall within their scope of practice authorized by statute.
The legislature defined, in similar manner, those persons who may write prescriptions for legend drugs in Florida. Chapter 465, F.S., the Florida Pharmacy Act, makes it a third degree felony for any person to sell or dispense legend drugs without first being furnished prescription. 465.003(7),465.015(2)(c), F.S. "Prescription" is defined as any order for legend drugs "by a duly licensed practitioner authorized by the laws of the State to prescribe such drugs." (e.s.) 465.003(13).
In the instant case, the BOARD acknowledges that it has never relied on any particular or specific phase in Chapter 463 as authorizing optometrists to prescribe and use legend drugs. Indeed, it asserts that:
[S]tatutory authority alone is insufficient to permit optometrists to use drugs. The scope of practice of optometry (including what is taught in the schools and colleges of optometry) must be considered. The Board of Optometry is responsible for determining the scope of practice.
(BOARD'S Proposed Final Order, proposed finding no. 188). It repeatedly asserts that it is the BOARD which defines the scope of practice of optometry, and that the definition is continually evolving. (BOARD's Proposed Final Order, proposed finding no. 194.) It broadly interprets the comprehensive "any other means or methods" language of Section 463.002(4) as including any means or methods taught by schools of optometry and recognized as standard methods by the BOARD. (BOARD's Proposed Final Order, proposed finding no. 50)
The BOARD fails to comprehend the limits of its power. It may only adopt rules consistent with Chapter 463 and for the purpose of carrying out the terms of the statute. 463.005. It may adopt standards of practice for licensed optometrists, Id. But it may not adopt standards which exceed or attempt to expand the scope of optometry as defined by Section 463.002(4). There may be, as the BOARD argues, good reasons for expanding the bounds of optometry, but the power to do so rests with the legislature, not the BOARD. Here, the statute does not authorize optometrists to prescribe or use legend drugs in their practice. The BOARD cannot adopt a rule which attempts to supply this authority. The proposed rule, standing alone, can neither add to nor vary the scope of practice defined by Section 463.002(4), F.S. See, 458.303(1)(a), 465.003(13), F.S.
Comparison of Chapter 463, F.S. With Statutes Regulating Other Health Care Practitioners. There is further support for the proposition that if the legislature had intended to authorize optometrists to prescribe and use legend drugs, it would have done so in clear and unmistakable language. It left little room for doubt when it enacted laws granting this authority to other health care practitioners when these statutes are examined, a common legislative scheme emerges: Each grant of authority is accompanied by a legislative restriction-- making the misuse of drugs an explicit ground for disciplinary action. 3/ See, statutes regulating the Professions of Medical Practice, 458.305(3), 458.331(1)(q); Osteopathy, 459.003(3), 459.015(1)(q); Podiatry, 461.003(3), 461.013(1)(p); Naturopathy, 462.01, 462.14(1)(h); Dentistry, 466.003, 466.017, 466.028(1)(q); Veterinary Medical Practice, 474.202(4), 474.214(1)(z), (aa), F.S.
Yet, Chapter 463 does not--either in the definition of optometry or in any disciplinary provision--clearly authorize optometrists to prescribe and use legend drugs in their practice. Indeed, misuse of legend drugs (by an optometrist inside or outside of his or her scope of practice) is not specified as a ground for discipline. The clear implication is that the legislature did not intend to authorize optometrists to prescribe and use legend drugs in their practice. If it had intended to do so, it is likely that it would have followed the same statutory scheme it used to grant such authority to other health care practitioners.
Scope of Optometry Is Defined by Statute, Not Various Schools of Optometry. As mentioned earlier, the BOARD urges that it is empowered to define and change the scope of optometry, based on what is taught in the various schools of optometry and what it approves as standard means and methods. This is not a permissible construction of Section 463.002(4), F.S., which defines the scope of optometry. The statutory definition does not expressly, or by reasonable inference, relate to what is taught in the schools of optometry.
If the legislature had intended such a result, it would have stated it--as it did in the law regulating osteopathic medicine. From at least 1941 to 1978, the scope of osteopathic medicine was defined as that system or school of medicine which "is taught and practiced in the standard colleges of osteopathy and Surgery . . . ." 459.01, F.S. (1975). "Standard colleges of osteopathy" were defined in terms of the educational requirements which must be met before one could obtain a degree of doctor of osteopathy. 459.08, F.S. (1975).
Less Weight Given Other Statutory Rules of Construction. In construing Chapter 463, F.S., and under the particular circumstances of this case, less weight is given other, countervailing, rules of statutory construction. While deference is accorded an agency's rule interpreting the statute in its charge, Department of Health and Rehabilitative Services v. Framat Realty, Inc., 407 So.2d 238 (Fla. 1st DCA 1981), such deference applies only to permissible interpretations. Id. The weight to be given an agency's current interpretation may be affected by its past interpretations to the contrary. Moreover, deference to an agency's interpretative power can never be used to justify a rule which is beyond its authority to adopt.
Although a Florida Attorney General's opinion is entitled to great weight in construing statutes, State v. Office of Comptroller, 416 So.2d 820 (Fla. 2d DCA 1982), where the opinions are conflicting and unclear--as they are in this case--they should be accorded less weight.
Deference is also accorded a rule which has been in effect for several sessions, without interference from the legislature or its Administrative Procedures Committee. Jax Liquors, Inc. v. Division of Alcoholic Beverages and Tobacco, 388 So.2d 1306 (Fla. 1st DCA 1980). But this principle has less effect when applied, as here, to an agency's policy statement never promulgated as a rule or subjected to the public notice and scrutiny requirements of Section 120.54, F.S.
Finally, legislative action--propose or defeated--may aid in construing a statute. 30 Fla. Jur., Statutes 103. But, in the instant case, recent legislative activity is inconclusive and provides little guidance to the correct interpretation of the statute. The 1975 statute creating the Study Commission sheds little light, Since the statute took a neutral position; and the Commission which subsequently studied the question took no definite position, and recommended no action.
Proposed Rule 21Q-3.10 Is Invalid, in Its Entirety. Proposed Rule 21Q- 3.10, in its entirety, constitutes an invalid exercise of delegated legislative authority. The rule--which purports to regulate the prescription and use of legend drugs by optometrists in the practice of optometry--clearly implies that optometrists have such authority under Chapter 463, F.S. They do not, and the BOARD has no power to confer it. Although subsection (2) of the rule does not expressly regulate the use of drugs by optometrists, it directly relates to the remaining--and--objectionable--portions of the proposed rule. There is no
evidence that the BOARD intended to adopt subsection (2) without the accompanying subsections (3)(4), and (5). Under these circumstances, subsection
(2) is also invalid.
III.
Unnecessary to Determine Validity of Economic Impact Statement. The adequacy of the BOARD's economic impact statement is not reached since the proposed rule which it addresses is deemed an invalid exercise of delegated legislative authority.
The Board's 1975 Policy Statement on the Use of Drugs by Optometrists is an Invalid "Rule." Section 120.52(15), F.S. defines a rule as:
(14) . . . each agency statement of general applicability that implements, interprets, or prescribes law or policy or describes the organization, procedures or practice requirements of an agency
and includes any form which imposes any requirement or Solicits any information not specifically required by statute
or by an existing rule. The term also includes the amendment or repeal of a rule . . . .
An agency's characterization of its statement is not controlling. If the statement is intended, by its own effect, to create rights, require compliance, or otherwise have the direct and consistent effect of law, it is a "rule," and invalid unless adopted in accordance with the rulemaking procedures of section 120.54, F.S. See, State Department of Administration v. Harvey, 356 So.2d 323 (Fla. 1st DCA 1977); State Department of Administration v. Stevens, 344 So.2d
291 (Fla. 1st DCA 1977). One of the goals of the Administrative Procedure Act was to abolish invisible policymaking--those "unwritten rules" which agency's can adopt, change, and enforce with unrestrained dis-cretion. Straughn v. O'Riordan, 338 So.2d 832, 834 (Fla. 1976).
In the instant case, the BOARD's 1975 policy statement on the use of drugs by ptometrists announced its interpretation of Chapter 463, and an attendant disciplinary policy, which it would follow in the future. This statement was generally applicab1e addressed and disseminated to all licensed optometrists in Florida. The BOARD intended that it be used and relied on in the future; optometrists were told that it was an important BOARD statement which they should read and retain for future reference. It was intended to create rights and require compliance. It effectively informed all licensed optometrists in Florida that they could lawfully prescribe and use legend drugs in their practice; and that if they did So providing they were individually competent, no disciplinary action would be taken against them. The statement was not incipient or emerging agency policy. See, McDonald v. Department of Banking and Finance, 346 So.2d 569 (Fla. 1st DCA 1977), It was not announced tentatively, or in uncertain terms, and it has remained--intact and unchanged-- as a statement of BOARD policy since 1975.
This 1975 policy statement is thus a "rule" within the meaning of Section 120.52(15), but was not adopted as such in accordance with Section
120.54 rulemaking procedures, It was adopted with lightning-like effect, without notice to affected persons, without providing them opportunity to comment or participate, and without eventual publication in the Florida Administrative Code. Hence, the BOARD's 1975 policy statement, dated November 12, 1975, constitutes an invalid exercise of delegated legislative authority.
Adoption and Rejection of Proposed Findings of Fact. The parties submitted proposed findings of fact which have been considered and, when appropriate, Incorporated in this order. To the extent they are not incorporated, they are rejected as not supported by the weight of credible evidence, subordinate, cumulative, immaterial, or unnecessary to resolution of the issues presented. Extensive findings were proposed pertaining to the training and education of optometrists; their ability to safely prescribe and use legend drugs in their practice; and the extent to which they have used--or now use--legend drugs in their practice, including their record of performance. Proposed findings on these subjects are rejected as immaterial to the dispositive issue--the BOARD's authority vel non to adopt a rule which, expressly or impliedly, authorizes optometrists to prescribe and use legend drugs in their practice of optometry.
Based on the foregoing, it is ORDERED:
That the Amended Petition to Invalidate Agency Rules, dated September 15, 1983, is granted. Accordingly,
Proposed Rule 21Q-3.10, as proposed by the BOARD and filed with the Department of State, is declared an invalid exercise of delegated legislative authority; and
The BOARD's written policy statement on the use of drugs in optometry, dated November 12, 1975, is declared an invalid exercise of delegated legislative authority.
DONE and ENTERED this 22nd day of March, 1984, in Tallahassee, Florida.
R. L. CALEEN, JR. Hearing Officer
Division of Administrative Hearings The Oakland Building
2009 Apalachee Parkway
Tallahassee, Florida 32301
(904) 488-9675
Filed with the Clerk of the Division of Administrative Hearings this 22nd day of March, 1984
ENDNOTES
1/ Petitioners also allege that this 1975 policy statement, never Promulgated as a rule, lacks Statutory authority. But this issue is not reached when a statement is challenged as an illicit rule. If an agency statement has the
effect of a rule, but was not Promulgated as such, the Statement is invalid, irrespective of its Substantive validity.
2/ In 1979, the 1939 definition was modified by adding the words "contact lenses."
3/ Although sometimes the authority to prescribe and use legend drugs is not made explicit in the definition of a particular profession's scope of practice, any doubt about the existence of such authority is eliminated by the wording of the accompanying disciplinary provision. See, Chapters 458, 459 and 462, F.S.
COPIES FURNISHED:
Kenneth G. Oertel, Esquire Segundo J Fernandez, Esquire Oertel & Hoffman, P.A.
646 Lewis State Bank Building Tallahassee, Florida 32301
Susan Tully, Esquire Department of Legal Affairs Suite 1601, The Capitol Tallahassee, Florida 32301
Leonard A. Carson, Esquire Michael Parrish, Esquire Carson & Lion, P.A.
253 East Virginia Street Tallahassee, Florida 32301
Fred Roche, Secretary Department of Professional Regulation
130 North Monroe Street Tallahassee, Florida 32301
Mildred Gardner, Executive Director
Department of Professional Regulation
Board of Optometry
130 North Monroe Street Tallahassee, Florida 32301
Liz Cloud, Chief
Bureau of Administrative Code 1802 Capitol Building
Tallahassee, Florida 32301
Carroll Webb, Executive Director Administrative Procedures Committee
120 Holland Building Tallahassee, Florida 32301
| Issue Date | Proceedings |
|---|---|
| Mar. 22, 1984 | CASE CLOSED. Final Order sent out. |
| Issue Date | Document | Summary |
|---|---|---|
| Mar. 22, 1984 | DOAH Final Order | A policy statement is a rule w/in the meaning of Sec 120.54(15) and as such is in accordance with Sec 120.54 procedures; proposed rule & policy invalid. |
