2000-07-14                     Senate Journal                      Page 3769
SB 78                                                                        
Message dated and received May 10, stating:                                    
                                                                               
Dear President Pearce:                                                         
                                                                               
Under the authority of art. II, sec. 15 of the Alaska Constitution, I          
have vetoed the following bill:                                                
                                                                               
SENATE BILL NO. 78 am H An Act relating to                                    
the use and prescription of pharmaceutical agents in                           
the practice of optometry.                                                     
                                                                               
This bill grants broad authority for optometrists in Alaska to                 
prescribe pharmaceutical agents relating to treatment of the eye,              
including oral and injectable drugs. This greatly expands optometrists'        
scope of practice regarding pharmaceuticals, which is now limited to           
the use of topical drugs.                                                      
                                                                               
                                                                               

2000-07-14                     Senate Journal                      Page 3770
SB 78                                                                        
I recognize the fact that many states currently allow optometrists to          
prescribe oral drugs. Fewer states have expanded this privilege to             
include the use of injectable drugs. I also recognize that a few states        
have recently rejected this proposed expansion of optometrist                  
privileges, citing concern for enlarging the scope of practice without         
adequate training and education. I share this concern.                         
                                                                               
I have faith that the Alaska State Board of Examiners in Optometry             
would do its best to regulate this new authority and would intend to           
require new testing of its licensees before granting this expanded             
license endorsement. However, the bill does not specifically require           
any new testing. Without a regulation change, under the language of            
this law, a licensee with a current endorsement to administer topical          
drugs would automatically be licensed to prescribe oral drugs and              
administer injected drugs.                                                     
                                                                               
The Legislature never sought the opinion of the medical community              
and, specifically, the Medical Board, when considering this bill. That         
was a failure to recognize this as a medical and health issue.                 
                                                                               
The bill asks the Board of Optometry to solicit the recommendations            
of the State Medical Board in establishing its examination and                 
education requirements for the pharmaceutical license endorsement.             
Despite this effort to involve the medical community in this process,          
members of the Alaska State Medical Board unanimously oppose this              
legislation, stating:                                                          
                                                                               
Optometrists do not have the clinical experience to                           
safely administer eye injections, intravenous and                              
intramuscular injections, and oral medications,                                
including some narcotics. Reading about the effect                             
and side effects of medications, or attending                                  
seminars, does not prepare an optometrist for                                  
complications related to patients' other medical                               
problems and chronic medications. The board's                                  
charge is to protect Alaskan patients; we believe                              
that this legislation would endanger patients.                                 
                                                                               
                                                                               

2000-07-14                     Senate Journal                      Page 3771
SB 78                                                                        
While I have high regard for the optometry profession in Alaska, I             
must, in the interest of public health and safety, heed the                    
recommendation of the medical community and veto this bill.                    
However, I remain open to the concept of expanding optometrists                
scope of practice regarding pharmaceuticals, provided we can                   
determine the appropriate perimeters of such a law and ensure the              
public safety in granting any expanded privileges.                             
                                                                               
					Sincerely,                                                                
					/s/                                                                       
					Tony Knowles                                                              
					Governor