Minutes of the

North Carolina State Board of Optometry

February 16- 18, 2007

Jane McKimmon Center

North Carolina State University

Raleigh, North Carolina



The North Carolina State Board of Examiners in Optometry met at the Jane McKimmon Center on the campus of North Carolina State University in Raleigh, North Carolina on Friday, February 16 through Sunday, February 18, 2007 to conduct the Board’s Winter 2007 examinations and for other purposes.  Present were Dr. William Rafferty, President, Dr. David Anderson, Secretary-Treasurer, and Drs. Joel Banks, Michael Clark, William Hendrix and Mr. Roger Mitchell and Ms. Mary Richardson, Members of the Board.  Also present were Dr. John Robinson, the Board’s Executive Director, Ms. Janice Peterson, the Administrative Secretary, and Ms. Sara Roberts, the Administrative Assistant.  Present briefly on Saturday afternoon during the break for lunch was Mr. Johnny Loper, the Board’s Attorney.  Present during the open session on Friday was Thaddeus Swank, Esq., Director  - Patient Information, American Academy of Ophthalmology’s Washington office.  Present as Clinical Examiners were Drs. Tom Bull, Kenneth Bumgarner, Ania Hamp, David King,  Magda Metwalli, Sandra Moore, John Miller, Eric Oberdorf,  Robert Rosenstein, and Matthew Vizithum.


Beginning at 4:00 P.M. on Friday afternoon, Members of the Board, Clinical Examiners and Staff met at the McKimmon Center to set up the examination stations and to review the examination format and scoring.  Promptly at 4:30 P. M. the President called the meeting of the Board to order.


Approval of Minutes.  On a motion by Dr. Banks, seconded by Dr. Anderson, the minutes of the meeting held November 9 – 12, 2006 as they appeared in the meeting notebook were unanimously approved.


Report of the President.    Dr. Rafferty reviewed his initiatives to update the Board’s Clinical/Practicum Examinations and its continuing education requirements.


He reported on the meeting held at the Board office on January 19 - 21, 2007 to review the current examination structure, the way that the scenarios are being prepared and presented, and to recommend steps to be taken in the interest of achieving  uniformity among the Clinical Examiners   Taking part in addition to himself and the Executive Director were Drs. Clark,  Hamp,  Rosenstein and MacQueen. He reviewed proposed changes to the examination process that would be forthcoming, indicating they were still in the stage of development and that implementation would occur as it becomes feasible to do so.  He recommended that this work continue in phases as changes are implemented and evaluated.


He raised for discussion the idea of eliminating the Board’s Examination’s Procedure Station in favor of requiring Part III of the National Boards. Further information will be presented at the next Board Meeting when this discussion continues.


In concluding his report Dr. Rafferty announced that he would make assignments by the next Board Meeting to consider changes in the current requirements for license renewal and issues related thereto.


On a motion by Dr. Clark, seconded by Dr. Hendrix and carried unanimously the report of the President was accepted.


Report of the Secretary/Treasurer.  The Secretary/Treasurer reviewed the Budget Report dated 07/01/06 thru 02/14/07.  Following the answering of questions by Dr. Anderson a motion was made by Dr. Clark and seconded by Ms. Richardson that the report of the Secretary/Treasurer be accepted.  The motion carried unanimously.


Report of the Executive Director.  The Executive Director reported that the programming  has been a very slow and painful process to this point in time; however, Mr. Dixon believes that we are now past the point where there was a risk that data in the ‘old system’ might be lost in transitioning to the new system.  We continue to operate the old system with a continuous updating from it to the new system; however,  the time is nearing when the old operating system will be shut down permanently and the new windows based operating system takes over as the sole data management system.  Mr. Dixon will be present at our March meeting to update you further.


I received a call from Ms. Sarah Allen in the Governor’s office recently concerning appointments to the Board as Members’ terms expire.   The Governor’s appointments secretary indicated that the Governor would like conflict of interest forms required under the new ethics laws completed by those individuals whose names are submitted to his office for  consideration for appointment to the Board prior to, rather than after, the expiration of  the term of office of the Member whose term will be expiring.  For as long as anyone can remember appointments to this Board have been for five years beginning in May of the year the retiring Member’s term expires, expiring in May five years later.  The elections held annually by the State Society for nominations of three names to be submitted to the Governor’s office for his consideration in making the appointment are held at its Spring Meeting  that is traditionally held in late May or early June.   To comply with the wishes of the Governor’s office the Society would have to hold a special meeting for this purpose during the winter or conduct the elections at its meeting in the Fall.  At the conclusion of our conversation I requested that we receive something in writing from the Governor’s office requesting in specific terms when or by what date the names of prospective appointees to the Board should be received in their office.  To date I have heard nothing more.


We received a request from a licensee for an opinion by the Board relating to the authority of a North Carolina optometrist to order imaging in the course of their practice when their examination and/or findings indicate that the patient’s vision problems and/or complaints might be related to a condition or conditions whose diagnosis is dependent upon findings that can only be obtained and/or verified through imaging.  The question is “can an optometrist duly licensed in North Carolina, in a proper case and upon specific findings, order imaging from a hospital or other facility offering imaging service?”  Further, “can a facility providing such imaging service(s) be denied payment by third party payers based solely on the fact that the procedure was ordered by an optometrist?”


We are in receipt of a newspaper advertisement offering ‘Free diabetic retinopathy screening’, the wording of which might be considered misleading.  A copy of that advertisement is in your meeting notebook.


A copy of a memorandum from the ‘Joint Legislative Administrative Procedure Oversight Committee’ that was received several weeks ago setting forth a number of ‘reporting requirements’ for occupational licensing boards is a part of your meeting book.   The memorandum sets forth the requirements for reporting and provides a listing of the information that is to be submitted.


Finally, It came to my attention that a board rule dealing with the prescribing of ‘controlled substances’ has been filed with the Administrative Rules Commission by the North Carolina Medical Board.  I took the liberty of using their proposed  rule as a template to draft a similar rule for your consideration.  I strongly recommend that the Board of Optometry take the steps necessary to enact this rule in the near future,  if for no other reason than be it in the interest of uniformity of rules among health care licensing Boards whose practitioners are authorized to use and prescribe controlled substances in the practice of their profession.


On a motion by Dr. Clark seconded by Ms. Richardson and carried unanimously the report of the Executive Director was accepted.


There was a brief discussion of the advertisement placed in a newspaper by an optometric practice advertising ‘Free diabetic retinopathy screening’. Following the discussion the President instructed the Executive Director to prepare a ‘letter of concern’ to be sent to the optometrist responsible for the advertisment by the Board addressing those statements in the advertisement it considered to be either misleading or having a potential to mislead.   Further, that the Board advise the practitioner(s) involved to cease such advertisements until such time they are reworded so as to clearly convey to the public information on diabetic eye disease, its diagnosis and treatment that comports with recognized studies and the prevailing standards of care of the diabetic patient.


Report of the Probable Cause Committee. Drs. Clark and Robinson presented the recommendations of the Probable Cause Committee in the matter of Juli Swain, OD. The Consent Order recommended by the Committee was agreed to by Dr. Swain and her attorney and signed by both.  Following a review of the Order and the answering of questions by Drs. Clark and Robinson, Mr. Mitchell moved  and Dr. Anderson seconded a motion that the Consent Order in this matter be approved and that it be signed  by the President  on behalf of the Board.  The motion carried with Mr. Mitchell, Ms. Richardson, Drs. Anderson, Banks and Clark voting aye and Dr. Hendrix voting nay.


Clinical Examiner’s Honorarium. On a motion by Dr. Banks, seconded by Dr. Hendrix, and carried unanimously the Board authorized payment of the hotel, travel and meal expenses for the Clinical Examiners and that they be given an honorarium in the amount of  $200.00 a day for each of the 3 days spent at the Winter 2007Clinical/Practicum Examinations.


Association of Regulatory Boards Regional Meeting/SECO International Meeting.  It was confirmed that three Members of the Board, Drs. Clark, Rafferty and Hendrix, would be traveling to Atlanta to attend the Regional ARBO Meeting and the SECO International.  Drs. Hendrix and Rafferty are traveling at the expense of other organizations; therefore the Board will only be responsible for those expenses that are not covered by their respective organizations where they serve as officers or trustees (ARBO and the Southern Council). The Executive Director will also be attending.  Reimbursement will be for travel, a maximum of four hotel nights and five days subsistence. Per diems are authorized for a maximum of five days for those Members not otherwise reimbursed by other organizations they represent. The Executive Director will be reimbursed for those expenses including travel, hotel and subsistence related to his attendance.


Association of Regulatory Boards and AOA Meetings in Boston in June, 2007.  Drs. Rafferty and Hendrix have indicated they would be attending the ARBO meeting in Boston. Dr. Rafferty’s expenses will be covered by ARBO. Expenses for Dr. Hendrix and other Board Members authorized to attend will be for travel and a maximum of four hotel nights, five days subsistence and five days per diem. In attending the ARBO and AOA meetings the Executive Director will be reimbursed for those expenses including travel, hotel and subsistence related to his attendance.  


Prior to adjourning for the evening Dr. Rafferty asked Mr. Swank if  he had conveyed his earlier offer to open a dialogue between the North Carolina Board of Optometry and his superiors at the Academy of Ophthalmology and their affiliate, the North Carolina Society of Eye Physicians and Surgeons?  If so, was there any response to that message?  Mr. Swank replied he had conveyed the message and that they were not interested.


 Meeting with the Board Attorney.   At 2:15 PM Saturday during the lunch hour Mr. Loper arrived at the McKimmon Center to meet with the Board.  On a motion by Dr. Anderson, seconded by Dr. Banks the Board voted unanimously to go in to executive session pursuant to GS 143-318.11(a)(3)  to receive information and counsel from the Board attorney involving potential disciplinary action against licensees who are believed to have pled guilty to a felony.   The Board received a legal briefing and analysis on such issue from its attorney, and asked questions about such potential disciplinary actions and received advice from its attorney.  When there were no further questions the Board voted unanimously to return to open session without taking any action or conducting a vote.


The first examination session began promptly as scheduled on Saturday morning, February 17th at 8:00 A.M. Fourteen candidates, their applications having been previously approved, appeared for examination over the two day period.


The next regularly scheduled meeting of the Board to review the results of the Winter 2007 Examinations and for other purposes will be held at the offices of the Board in Wallace, North Carolina beginning on Friday, March 30, 2007 ending no later than 5:00 PM on Saturday March 31, 2007.


                                                                                                Approved 03/30/07

                                                                                                                                Wallace, NC