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.