CHAPTER 353. CONTACT LENS PRESCRIPTION ACT
OCCUPATIONS CODE
TITLE 3. HEALTH PROFESSIONS
SUBTITLE F. PROFESSIONS RELATED TO EYES AND VISION
CHAPTER 353. CONTACT LENS PRESCRIPTION ACT
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 353.001. SHORT TITLE. This chapter may be cited as the
Contact Lens Prescription Act.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.002. DEFINITIONS. In this chapter:
(1) "Board" means the executive commissioner of the Health and
Human Services Commission or the Department of State Health
Services, as consistent with the respective duties of the
executive commissioner or department under the laws of this
state.
(2) "Department" means the Department of State Health Services
or the Health and Human Services Commission, as consistent with
the respective duties of those agencies under the laws of this
state.
(2-a) "Direct communication" includes communication by
telephone, facsimile, or electronic mail.
(3) "Disposable contact lenses" means soft contact lenses that:
(A) are dispensed in sealed packages;
(B) are sterilized and sealed by the manufacturer; and
(C) according to the physician's, optometrist's, or therapeutic
optometrist's instructions concerning wear, have a recommended
lens replacement interval of less than three months.
(4) "Optician" means a person, other than a physician,
optometrist, therapeutic optometrist, or pharmacist, who is in
the business of dispensing contact lenses.
(5) "Optometrist" means a person licensed to practice optometry
or therapeutic optometry by the Texas Optometry Board.
(6) "Pharmacist" means a person licensed to practice pharmacy by
the Texas State Board of Pharmacy.
(7) "Physician" means a person licensed to practice medicine by
the Texas State Board of Medical Examiners.
(8) "Therapeutic optometrist" means a person licensed to
practice therapeutic optometry by the Texas Optometry Board.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
101, Sec. 2.001, eff. September 1, 2005.
Sec. 353.003. EFFECT OF CHAPTER. This chapter does not prevent
or restrict a physician from:
(1) treating or prescribing for a patient; or
(2) directing or instructing a person under the physician's
control or supervision who assists a patient according to a
specific direction, order, instruction, or prescription.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.004. PUBLIC INFORMATION ON PRESCRIPTION RELEASE. (a)
The board and the Texas Optometry Board shall prepare and provide
to the public and appropriate state agencies information
regarding the release and verification of contact lens
prescriptions.
(b) The board may adopt rules necessary to implement this
section.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
101, Sec. 2.002, eff. September 1, 2005.
Sec. 353.005. RULES. (a) The executive commissioner of the
Health and Human Services Commission shall adopt rules, including
rules that require a person dispensing contact lenses to maintain
certain information when verifying a prescription under Section
353.1015, as necessary to:
(1) govern and implement verification procedures under Section
353.1015; and
(2) enter into interagency and other agreements to implement and
enforce this chapter.
(b) The executive commissioner of the Health and Human Services
Commission and the Texas Optometry Board shall each adopt rules
relating to contact lens prescriptions and the dispensing of
contact lenses, including rules that allow for interagency
agreements, as necessary to implement and enforce this chapter.
(c) In implementing rules under Subsection (b), the executive
commissioner of the Health and Human Services Commission and the
Texas Optometry Board:
(1) shall cooperate with one another as necessary to adopt rules
that are consistent with the rules adopted by the other agency;
and
(2) may consult with the Texas State Board of Medical Examiners
and the Texas State Board of Pharmacy.
Added by Acts 2005, 79th Leg., Ch.
101, Sec. 2.003, eff. September 1, 2005.
SUBCHAPTER B. DISPENSING CONTACT LENSES; PERMIT
Sec. 353.051. CONTACT LENS DISPENSER. Contact lenses may be
dispensed only by:
(1) a physician, optometrist, therapeutic optometrist, or
pharmacist;
(2) an employee of a physician, optometrist, therapeutic
optometrist, or pharmacist who performs contact lens dispensing
services only under the direct supervision and control of the
physician, optometrist, therapeutic optometrist, or pharmacist;
or
(3) an optician who holds a contact lens dispensing permit
issued under this subchapter.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.052. CONTACT LENS DISPENSING BY BUSINESS ENTITY. (a)
A business entity that dispenses contact lenses to a person in
this state:
(1) must obtain a contact lens dispensing permit in the entity's
name; and
(2) may not dispense the lenses to a person in this state
through an employee or other person who holds a contact lens
dispensing permit.
(b) A business entity that has at least 10 locations may obtain
a single permit for the entity and its employees. An employee of
an entity with a permit under this subsection is not required to
obtain a separate permit.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.053. REQUIREMENTS FOR PERMIT ISSUANCE. The board shall
issue a contact lens dispensing permit to an applicant who:
(1) agrees in writing to comply with state and federal laws and
regulations regarding selling, delivering, or dispensing contact
lenses;
(2) has not had a contact lens dispensing permit revoked or
canceled for cause during the two-year period preceding the
application date;
(3) provides the board with the trade name and address of each
location where the applicant intends to conduct business;
(4) provides the board with other information the board
reasonably requires; and
(5) pays the required permit fee.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.054. TERM OF PERMIT. (a) A contact lens dispensing
permit issued under this subchapter is valid for one year.
(b) The board may temporarily extend or shorten the term of a
permit to provide for the staggered renewal of permits or for the
annual renewal of all permits on the same date. The board shall
prorate the permit fee to accomplish that purpose.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.055. PERMIT RENEWAL. (a) To renew a contact lens
dispensing permit, a permit holder must apply in the manner
prescribed by board rule and pay the permit fee.
(b) The board may not require an applicant for renewal of a
permit to provide more information than is required for issuance
of an original permit.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.056. ANNUAL PERMIT FEE. (a) The board may adopt
annual permit fees in amounts reflecting the cost of
administering the provisions of this chapter relating to
regulating permit holders.
(b) Until changed by the board, the annual permit fee for a
contact lens dispensing permit is:
(1) $10 for an optician who has registered with the department;
(2) $25 for an optician who has not registered with the
department; and
(3) $100 for a business entity.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
SUBCHAPTER C. SALE OR DELIVERY OF CONTACT LENSES
Sec. 353.101. PROHIBITED SELLING OR DISPENSING. (a) A person,
other than the prescribing physician, optometrist, or therapeutic
optometrist, may not fill a contact lens prescription or sell or
dispense contact lenses to a consumer in this state unless the
person:
(1) receives from the prescribing physician, optometrist, or
therapeutic optometrist or the consumer, directly or by
facsimile, a contact lens prescription that has not expired and
that conforms to the requirements of this chapter; or
(2) verifies by direct communication a contact lens prescription
to be filled.
(b) A person receiving a direct communication under Subsection
(a)(2) shall maintain a record of the communication.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
101, Sec. 2.004, eff. September 1, 2005.
Sec. 353.1015. VERIFICATION PROCEDURE. (a) When seeking
verification of a contact lens prescription, a person dispensing
contact lenses shall provide the prescribing physician,
optometrist, or therapeutic optometrist with the following
information:
(1) the patient's full name and address;
(2) contact lens power, manufacturer, base curve or appropriate
designation, and diameter, as appropriate;
(3) quantity of lenses ordered;
(4) the date on which the patient requests lenses to be
dispensed;
(5) the date and time of the verification request; and
(6) the name, telephone number, and facsimile number of a person
at the contact lens dispenser's company with whom to discuss the
verification.
(b) A prescription is considered verified under this section if:
(1) the prescribing physician, optometrist, or therapeutic
optometrist by a direct communication confirms that the
prescription is accurate;
(2) the prescribing physician, optometrist, or therapeutic
optometrist informs the person dispensing the contact lenses that
the prescription is inaccurate and provides the correct
prescription information; or
(3) the prescribing physician, optometrist, or therapeutic
optometrist fails to communicate with the person dispensing the
contact lenses not later than the eighth business hour after the
prescribing physician, optometrist, or therapeutic optometrist
receives from the person dispensing the contact lenses the
request for verification or within another similar period
specified by rule.
(c) If a prescribing physician, optometrist, or therapeutic
optometrist timely informs the person dispensing the contact
lenses that the prescription is inaccurate or invalid, the person
may not dispense the contact lenses.
(d) If a prescribing physician, optometrist, or therapeutic
optometrist notifies the person dispensing the contact lenses
that the prescription is inaccurate or invalid, the prescribing
physician, optometrist, or therapeutic optometrist shall:
(1) specify the basis for the inaccuracy or invalidity of the
prescription; and
(2) correct the prescription.
Added by Acts 2005, 79th Leg., Ch.
101, Sec. 2.005, eff. September 1, 2005.
Sec. 353.102. ACCURACY REQUIRED. A person who dispenses contact
lenses under this chapter from a contact lens prescription shall
fill the prescription accurately subject to Section 353.103.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.103. AUTHORIZED MODIFICATION OF PRESCRIPTION. (a) If
a patient presents a contact lens prescription to be filled or
asks a permit holder to verify a contact lens prescription under
Section 353.1015, but requests that fewer than the total number
of lenses authorized by the prescription be dispensed, the person
dispensing the lenses shall note on the prescription or
verification:
(1) the number of lenses dispensed;
(2) the number of lenses that remain eligible to be dispensed
under the prescription; and
(3) the name, address, telephone number, and license or permit
number of the person dispensing the lenses.
(b) A notation under Subsection (a) is a permanent modification
of the prescription. Except as provided by this subsection, a
contact lens prescription may not be modified.
(c) The person dispensing the lenses shall:
(1) maintain a photocopy of the prescription or verification, as
modified, in the person's records as if the copy were the
prescription to be filled; and
(2) return a prescription to the patient so that the patient may
have the additional lenses dispensed elsewhere.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
101, Sec. 2.006, eff. September 1, 2005.
Sec. 353.104. EMERGENCY REFILL. (a) If a patient needs an
emergency refill of the patient's contact lens prescription, a
physician, optometrist, or therapeutic optometrist may telephone
or fax the prescription to a person authorized to dispense
contact lenses under Section 353.051 or may verify a prescription
under Section 353.1015.
(b) A fax or telephone record received under Subsection (a) must
include the name, address, telephone number, and license number
of the physician, optometrist, or therapeutic optometrist.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
101, Sec. 2.006, eff. September 1, 2005.
Sec. 353.105. ALTERATION OF PRESCRIPTION PROHIBITED. (a)
Except as provided by Subsection (b) and Section 353.103, a
person dispensing contact lenses may not alter a contact lens
prescription.
(b) A person dispensing contact lenses may fill a contact lens
prescription that requires a contact lens manufactured by a
particular company with another lens manufactured by that company
if the lens required by the prescription and the lens with which
the prescription is filled are the same lens but are sold by the
company under multiple labels to different contact lens
dispensers.
Added by Acts 2005, 79th Leg., Ch.
101, Sec. 2.007, eff. September 1, 2005.
SUBCHAPTER D. CONTACT LENS PRESCRIPTIONS
Sec. 353.151. DIRECTIONS FOR INDEPENDENT OPTICIAN; DELEGATION.
(a) If a physician's directions, instructions, or orders are to
be performed or a physician's prescription is to be filled by an
optician who is independent of the physician's office, the
directions, instructions, orders, or prescription must be:
(1) in writing or verified under Section 353.1015;
(2) of a scope and content and communicated to the optician in a
form and manner that, in the professional judgment of the
physician, best serves the health, safety, and welfare of the
physician's patient; and
(3) in a form and detail consistent with the optician's skill
and knowledge.
(b) A person who holds a contact lens dispensing permit issued
under Subchapter B may measure the eye or cornea and may evaluate
the physical fit of lenses for a particular patient of a
physician if the physician has delegated in writing those
responsibilities regarding that patient to the person in
accordance with Subsection (a) and Section 351.005.
(c) If a physician notes on a spectacle prescription "fit for
contacts" or similar language and has, as required by Subsections
(a) and (b), specifically delegated to a specific optician the
authority to make the additional measurements and evaluations
necessary for a fully written contact lens prescription, the
optician may dispense contact lenses to the patient even though
the prescription is less than a fully written contact lens
prescription.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
101, Sec. 2.008, eff. September 1, 2005.
Sec. 353.152. REQUIREMENTS FOR CONTACT LENS PRESCRIPTION. (a)
A contact lens prescription must contain, at a minimum:
(1) the patient's name;
(2) the date the prescription was issued;
(3) the manufacturer of the contact lens to be dispensed, if
needed;
(4) the expiration date of the prescription;
(5) the signature of the physician, optometrist, or therapeutic
optometrist or a verification of the prescription described by
Section 353.1015;
(6) if the prescription is issued by an optometrist,
specification information required by Texas Optometry Board rule;
and
(7) if the prescription is issued by a physician, specification
information required by Texas State Board of Medical Examiners
rule.
(b) The Texas Optometry Board and the Texas State Board of
Medical Examiners may adopt rules regarding the contents of a
prescription for contact lenses.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
101, Sec. 2.009, eff. September 1, 2005.
Sec. 353.153. TERM OF PRESCRIPTION. A physician, optometrist,
or therapeutic optometrist may not issue a contact lens
prescription that expires before the first anniversary of the
date the patient's prescription parameters are determined, unless
a shorter prescription period is warranted by the patient's
ocular health or by potential harm to the patient's ocular
health.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.154. SHORT-TERM PRESCRIPTION. If a physician,
optometrist, or therapeutic optometrist writes a contact lens
prescription for a period of less than one year, the physician,
optometrist, or therapeutic optometrist shall:
(1) give the patient a verbal explanation of the reason for the
action at the time of the action; and
(2) maintain in the patient's records a written explanation of
the reason.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.155. EXTENSION OF PRESCRIPTION. (a) A physician,
optometrist, or therapeutic optometrist may extend the expiration
date for a contact lens prescription without completing another
eye examination.
(b) On request by a patient, a prescribing physician,
optometrist, or therapeutic optometrist shall authorize at least
once a two-month extension of the patient's contact lens
prescription. The physician, optometrist, or therapeutic
optometrist may extend the prescription in accordance with
Section 353.104.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.156. PATIENT ACCESS TO PRESCRIPTION; TIMING. (a) A
physician, optometrist, or therapeutic optometrist who performs
an eye examination and fits a patient for contact lenses shall:
(1) prepare and give a contact lens prescription to the patient;
and
(2) as directed by any person designated to act on behalf of the
patient, provide the prescription or verify the prescription as
provided by Section 353.1015.
(b) If the contact lens prescription results from an initial or
annual eye examination, the physician, optometrist, or
therapeutic optometrist shall prepare and give the prescription
to the patient at the time the physician, optometrist, or
therapeutic optometrist determines the parameters of the
prescription.
(c) On receipt of a prescription request from a patient who did
not receive an original contact lens prescription during an
initial or annual eye examination, the physician, optometrist, or
therapeutic optometrist shall provide the patient with the
prescription at any time during which the prescription is valid.
Except as provided by Section 353.158(1), if the patient requests
the physician, optometrist, or therapeutic optometrist to deliver
the prescription to the patient or to another person, the
physician, optometrist, or therapeutic optometrist may charge to
the patient the cost of delivery.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
101, Sec. 2.010, eff. September 1, 2005.
Sec. 353.157. LIMITATIONS ON OR REFUSAL TO GIVE PRESCRIPTION.
(a) A physician, optometrist, or therapeutic optometrist may
exclude categories of contact lenses from a contact lens
prescription if the exclusion is clinically indicated.
(b) Notwithstanding Section 353.156, a physician, optometrist,
or therapeutic optometrist may refuse to give a contact lens
prescription to a patient if:
(1) the patient's ocular health presents a contraindication for
contact lenses;
(2) refusal is warranted due to potential harm to the patient's
ocular health;
(3) the patient has a medical condition indicating that:
(A) the patient's ocular health would be damaged if the
prescription were released to the patient; or
(B) further monitoring of the patient is needed;
(4) the patient has not paid for the examination and fitting or
has not paid other financial obligations to the physician,
optometrist, or therapeutic optometrist if the patient would have
been required to make an immediate or similar payment if the
examination revealed that ophthalmic goods were not required; or
(5) the request is made after the first anniversary of the date
of the patient's last eye examination.
(c) If a physician, optometrist, or therapeutic optometrist
refuses to give a patient the patient's contact lens prescription
for a reason permitted under Subsection (b), the physician,
optometrist, or therapeutic optometrist must:
(1) give the patient a verbal explanation of the reason for the
action at the time of the action; and
(2) maintain in the patient's records a written explanation of
the reason.
(d) Subsection (b) does not prohibit a physician, optometrist,
or therapeutic optometrist from giving a patient the patient's
contact lens prescription.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.158. PROHIBITED ACTION BY PHYSICIAN, OPTOMETRIST, OR
THERAPEUTIC OPTOMETRIST. A physician, optometrist, or
therapeutic optometrist may not:
(1) charge a patient a fee in addition to or as part of the
examination fee and fitting fee as a condition for issuing or
verifying a contact lens prescription; or
(2) condition the availability to a patient of an eye
examination, a fitting for contact lenses, the issuance or
verification of a contact lens prescription, or a combination of
those services on a requirement that the patient agree to
purchase contact lenses or other ophthalmic goods from the
physician, optometrist, or therapeutic optometrist or from a
specific ophthalmic dispenser.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Amended by:
Acts 2005, 79th Leg., Ch.
101, Sec. 2.011, eff. September 1, 2005.
Sec. 353.159. WAIVER OR DISCLAIMER OF LIABILITY PROHIBITED. A
contact lens prescription may not contain, and a physician,
optometrist, or therapeutic optometrist may not require a patient
to sign, a form or notice that waives or disclaims the liability
of the physician, optometrist, or therapeutic optometrist for the
accuracy of:
(1) the eye examination on which a contact lens prescription
provided to the patient is based; or
(2) a contact lens prescription provided to the patient.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
SUBCHAPTER E. LIABILITY AND ENFORCEMENT
Sec. 353.201. LIABILITY FOR USE OF PRESCRIPTION. A physician,
optometrist, or therapeutic optometrist is not liable for a
patient's subsequent use of a contact lens prescription if:
(1) the physician, optometrist, or therapeutic optometrist does
not reexamine the patient; and
(2) the patient's condition, age, general health, and
susceptibility to an adverse reaction caused by or related to the
use of contact lenses or other factors result in the patient no
longer being a proper candidate for the contact lens prescribed.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.202. DISCIPLINARY ACTION. The board may suspend or
revoke a person's contact lens dispensing permit or place the
permit holder on probation for a violation of this chapter.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.2025. EMERGENCY SUSPENSION. (a) The department shall
temporarily suspend the permit of a permit holder if the
department determines from the evidence or information presented
to it that continued practice by the permit holder would
constitute a continuing and imminent threat to the public
welfare.
(b) A permit may be suspended under this section without notice
or hearing on the complaint if:
(1) action is taken to initiate proceedings for a hearing before
the State Office of Administrative Hearings simultaneously with
the temporary suspension; and
(2) a hearing is held as soon as practicable under this chapter
and Chapter 2001, Government Code.
(c) The State Office of Administrative Hearings shall hold a
preliminary hearing not later than the 14th day after the date of
the temporary suspension to determine if there is probable cause
to believe that a continuing and imminent threat to the public
welfare still exists. A final hearing on the matter shall be held
not later than the 61st day after the date of the temporary
suspension.
Added by Acts 2003, 78th Leg., ch. 326, Sec. 3, eff. Sept. 1,
2003.
Sec. 353.203. SEPARATE VIOLATIONS. A course of conduct that
involves more than one prescription is a separate violation for
each prescription dispensed in violation of this chapter.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.204. ENFORCEMENT PROCEEDINGS. (a) The appropriate
regulatory agency, the attorney general, or the district or
county attorney for the county in which an alleged violation of
this chapter occurs shall, on receipt of a verified complaint,
initiate an appropriate administrative or judicial proceeding to
enforce this chapter and the rules adopted under this chapter.
(b) Except as otherwise provided by this section, the board is
responsible for enforcing this chapter.
(c) The Texas State Board of Medical Examiners is responsible
for enforcing this chapter with regard to a violation of this
chapter by a physician. A violation of this chapter by a
physician is considered to be a violation of Subtitle B.
(d) The Texas Optometry Board is responsible for enforcing this
chapter with regard to a violation of this chapter by an
optometrist or a therapeutic optometrist. A violation of this
chapter by an optometrist or a therapeutic optometrist is
considered to be a violation of Chapter 351.
(e) The Texas State Board of Pharmacy is responsible for
enforcing this chapter with regard to a violation of this chapter
by a pharmacist. A violation of this chapter by a pharmacist is
considered to be a violation of Subtitle J, other than Chapter
567.
(f) The attorney general or an attorney representing the state
may bring an action for an injunction to prohibit a person from
violating this chapter or a rule adopted under this chapter.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.205. ADMINISTRATIVE PENALTY. The board may impose an
administrative penalty of not more than $1,000 for a violation of
this chapter.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.206. CIVIL PENALTY. In addition to granting injunctive
or other relief provided by law, a court may impose a civil
penalty for a violation of this chapter or a rule adopted under
this chapter.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.
Sec. 353.207. CRIMINAL PENALTY. (a) A person commits an
offense if the person violates this chapter.
(b) An offense under this section is a Class B misdemeanor.
Acts 1999, 76th Leg., ch. 388, Sec. 1, eff. Sept. 1, 1999.