Legislature(2017 - 2018)BARNES 124

04/01/2017 01:00 PM LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Delayed to 3:00 PM --
*+ HB 124 BENEFIT CORPORATIONS TELECONFERENCED
Heard & Held
-- Public Testimony --
*+ HB 36 TAX: INCOME FROM NON C CORP ENTITIES TELECONFERENCED
Heard & Held
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 103 OPTOMETRY & OPTOMETRISTS TELECONFERENCED
Moved CSHB 103(L&C) Out of Committee
                 HB 103-OPTOMETRY & OPTOMETRISTS                                                                            
                                                                                                                                
3:04:06 PM                                                                                                                    
                                                                                                                                
CHAIR KITO  announced that the  first order of business  would be                                                               
HOUSE  BILL  NO.  103,  "An  Act  relating  to  the  practice  of                                                               
optometry; and  providing for  an effective  date."   [Before the                                                             
committee was CSHB 103(HSS).]                                                                                                 
                                                                                                                                
3:04:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE IVY  SPOHNHOLZ, Alaska State  Legislature, Juneau,                                                               
Alaska,  as the  sponsor, re-introduced  HB 103.   She  explained                                                               
that HB  103 would update  the Board of [Examiners  in] Optometry                                                               
to be  more in line with  the practices that are  consistent with                                                               
those other  boards overseeing health professions  throughout the                                                               
state  of Alaska.    It would  give the  board  the authority  to                                                               
regulate  its   own  practice  and   would  move   management  of                                                               
optometrists away from the legislature and into the board.                                                                      
                                                                                                                                
3:05:45 PM                                                                                                                    
                                                                                                                                
CHAIR  KITO moved  to adopt  Amendment 1,  labeled 30-LS0459\J.5,                                                               
Bruce, 3/28/17, which read:                                                                                                     
                                                                                                                                
     Page 2, lines 6 - 7:                                                                                                       
          Delete "standards for the practice of optometry                                                                   
     as provided"                                                                                                           
     Insert "whether optometry practice procedures or                                                                       
     policies comply with acceptable standards of the                                                                       
     practice of optometry, as provided"                                                                                    
                                                                                                                                
3:05:57 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
3:06:34 PM                                                                                                                    
                                                                                                                                
CHAIR KITO again moved to adopt Amendment 1.                                                                                    
                                                                                                                                
3:07:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON said  he  is unable  to  tell what  the                                                               
[proposed] change is.                                                                                                           
                                                                                                                                
REPRESENTATIVE SPOHNHOLZ explained Amendment  1 would tighten the                                                               
definition  of  standard   of  practice  in  a   manner  that  is                                                               
consistent with the  exact language that is used by  the Board of                                                               
Nursing.  She said the amendment  is at the recommendation of the                                                               
Department of Law  to ensure that the definition  of the standard                                                               
of  practice  is clearly  defined  as  complying with  acceptable                                                               
standards of practice of optometry.   According to the Department                                                               
of Law, she added, this  would tighten the definition of standard                                                               
of practice in a way that makes it more useful.                                                                                 
                                                                                                                                
3:07:59 PM                                                                                                                    
                                                                                                                                
There being no objection, Amendment 1 was adopted.                                                                              
                                                                                                                                
3:08:04 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
3:08:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON moved to  adopt Amendment 2, labeled 30-                                                               
LS0459\J.1, Bruce, 3/27/17, which read:                                                                                         
                                                                                                                                
     Page 1, line 9, following "disease":                                                                                   
     Insert "as provided under AS 08.72.272"                                                                                
                                                                                                                                
CHAIR KITO objected for purposes of discussion.                                                                                 
                                                                                                                                
3:08:52 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON explained Amendment  2.  He related that                                                               
in oral testimony and  written comments, several ophthalmologists                                                               
stated  that they  don't prescribe  anything  more powerful  than                                                               
hydrocodone, which, to  his knowledge, was not  controverted.  He                                                               
further related  that these ophthalmologists stated  that eyes do                                                               
not respond  well to pain medication.   He said that  as he reads                                                               
the bill, it would provide  that optometrists could prescribe any                                                               
[pharmaceutical] ever invented.                                                                                                 
                                                                                                                                
REPRESENTATIVE JOSEPHSON  further explained  that Amendment  2 is                                                               
consistent  with  a  forthcoming  amendment  which  would  repeal                                                               
language  that  would  give optometrists  the  authority  through                                                               
their board to prescribe anything they  want to.  Amendment 2, he                                                               
stated, would return to existing  language in Alaska Statute (AS)                                                               
08.72.272.  He  said it would be hard to  say optometrists didn't                                                               
make  certain  arguments about  the  need  to oversee  their  own                                                               
practice.  However, he continued,  they didn't make any arguments                                                               
in testimony  or in writing about  why they needed to  expand the                                                               
kinds of prescriptions they make.   Given the crisis the state is                                                               
confronted with,  he said he  doesn't know why that  expansion is                                                               
necessary, which is why he is offering Amendment 2.                                                                             
                                                                                                                                
3:11:13 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD inquired as  to what AS 08.72.272                                                               
describes in detail.                                                                                                            
                                                                                                                                
REPRESENTATIVE  JOSEPHSON replied  that Amendment  2 would  bring                                                               
this  back  to current  law  that  exists under  [AS  08.72.272],                                                               
Pharmaceutical  Agents, subsection  (a), which  says optometrists                                                               
can prescribe  for assorted things.   Amendment 2, he  said, says                                                               
the  status  quo will  prevail  and  optometrists will  have  the                                                               
authority that they currently have to prescribe.                                                                                
                                                                                                                                
3:12:11 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SPOHNHOLZ rebutted that part  of the intent of the                                                               
legislation  was to  simplify and  to streamline  the legislation                                                               
authorizing  the [Board  of Examiners  in  Optometry] to  oversee                                                               
their practice.   She related  that [the board] has  testified it                                                               
will continue to work with  the four-day limitation on the supply                                                               
of opioids, for  example.  Also, she  continued, other regulation                                                               
is being put  into practice regarding the  opioid epidemic, which                                                               
she strongly feels the legislature  needs to address by advancing                                                               
HB 159 for  that purpose.  She said she  understands the maker of                                                               
the amendment's  concerns, but  the statutory  language currently                                                               
in place  is outdated and  leaves [legislators] in a  position of                                                               
overseeing specific kinds of  medications for which [legislators]                                                               
don't  have the  expertise  to  be managing.    Therefore, it  is                                                               
better  to have  this authority  placed at  the board  level, she                                                               
stated.                                                                                                                         
                                                                                                                                
3:13:19 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE BIRCH spoke against Amendment  2.  He recalled the                                                               
committee  hearing  testimony  about what  an  optometrist  could                                                               
prescribe  and  that  nurses  could  not  prescribe  [narcotics].                                                               
However,  he continued,  he was  informed by  a friend  who is  a                                                               
nurse that  nurses can prescribe  narcotics in Alaska,  have done                                                               
so for  decades, and that  nurses need the same  Drug Enforcement                                                               
Administration  (DEA)  authority  as  a physician  or  any  other                                                               
clinician.    Therefore,  he  said,  he  is  not  troubled  about                                                               
providing the latitude proposed [in HB 103].                                                                                    
                                                                                                                                
3:14:01 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KNOPP asked  whether Section  4, page  2, of  the                                                               
bill does what the maker of the amendment is trying to do.                                                                      
                                                                                                                                
REPRESENTATIVE JOSEPHSON  responded, "This brings us  back to the                                                               
overall."   What he means,  he continued,  is it makes  the board                                                               
the ultimate  decider about what  those prescriptions  should be,                                                               
and he  is not comfortable with  that.  The people  who testified                                                               
have spent  more time than  anyone else  working on eye  care and                                                               
they said  they never use  more than hydrocodone.   Under current                                                               
law, he continued, "optometrists can  do that very thing, but [HB                                                               
103] would lift that and say,  'prescribe what you want,' if that                                                               
[is]  what  the board  says,  'prescribe  what  you will.'"    He                                                               
further noted  it means that  the attorney general would  have to                                                               
look  at this  language  and determine  whether  the board  acted                                                               
consistent with  the language [of HB  103 in section 4,  page 2],                                                               
and he  would conclude that as  long as they establish  the what,                                                               
where, and  why of  what they  were doing,  maybe they  would say                                                               
yes.  "But," he added, "that is  our point   we'd make it valid                                                                 
and ? there's that argument  that the attorney general would have                                                               
to give them that authority."                                                                                                   
                                                                                                                                
3:16:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL  offered his understanding  that optometrists                                                               
can already prescribe certain controlled  substances.  He said he                                                               
doesn't  see  that as  being  a  problem in  the  past;  it is  a                                                               
responsibility that [optometrists] have handled.                                                                                
                                                                                                                                
3:16:30 PM                                                                                                                    
                                                                                                                                
CHAIR KITO maintained his objection to Amendment 2.                                                                             
                                                                                                                                
A roll call  vote was taken.  Representatives  Josephson voted in                                                               
favor of  Amendment 2.  Representatives  Knopp, Sullivan-Leonard,                                                               
Wool, Birch, and  Kito voted against it.   Therefore, Amendment 2                                                               
failed by a vote of 1-5.                                                                                                        
                                                                                                                                
3:17:10 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON moved to  adopt Amendment 3, labeled 30-                                                               
LS0459\J.2, Bruce, 3/27/17, which read:                                                                                         
                                                                                                                                
     Page 2, lines 20 - 24:                                                                                                     
          Delete all material.                                                                                                  
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
3:17:12 PM                                                                                                                    
                                                                                                                                
CHAIR KITO objected.                                                                                                            
                                                                                                                                
REPRESENTATIVE JOSEPHSON  explained Amendment 3.   He said  it is                                                               
the same  argument as Amendment 2,  and that he is  not convinced                                                               
the board  has the  training, education,  and experience  to make                                                               
decisions about  pharmaceutical agents in  every case.   While he                                                               
is comfortable in some cases,  [the bill proposes] to expand this                                                               
in a way that is, in  his view, far beyond [the board's] training                                                               
and therefore he is offering Amendment 3.                                                                                       
                                                                                                                                
REPRESENTATIVE  SPOHNHOLZ  opposed Amendment  3.    She said  her                                                               
comments on the  amendment are much the same as  for Amendment 2.                                                               
The  language  in  Section  4,  she stated,  is  clear  that  the                                                               
pharmaceutical  agent  prescribed  needs to  be  consistent  with                                                               
their standards of practice.   Like optometrists, there are other                                                               
professions  that  have the  authority  to  practice within  this                                                               
scope that have not gone to  medical school and therefore are not                                                               
under the [State Medical Board].                                                                                                
                                                                                                                                
REPRESENTATIVE BIRCH  said he has  similar concerns as  he voiced                                                               
before in that if the board  is recognized as having the capacity                                                               
and  the  ability  to  make  those  recommendations,  it  is  not                                                               
dissimilar from other clinicians in that line of work.                                                                          
                                                                                                                                
3:19:00 PM                                                                                                                    
                                                                                                                                
CHAIR KITO maintained his objection to Amendment 3.                                                                             
                                                                                                                                
A roll  call vote was  taken.  Representative Josephson  voted in                                                               
favor of  Amendment 3.  Representatives  Birch, Sullivan-Leonard,                                                               
Knopp, Wool, and  Kito voted against it.   Therefore, Amendment 3                                                               
failed to be adopted by a vote of 1-5.                                                                                          
                                                                                                                                
3:19:30 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON moved to  adopt Amendment 4, labeled 30-                                                               
LS0459\J.3, Bruce, 3/27/17, which read:                                                                                         
                                                                                                                                
     Page 2, following line 24:                                                                                                 
     Insert a new bill section to read:                                                                                         
        "* Sec.  5. AS 08.72.273  is repealed  and reenacted                                                                  
     to read:                                                                                                                   
          Sec. 08.72.273. Non-invasive procedures. Except                                                                     
     as  provided in  AS 08.72.278, a  licensee may  perform                                                                    
     non-invasive procedures including                                                                                          
               (1)  removing superficial bodies from the                                                                        
     eye and its appendages;                                                                                                    
              (2)  epilating misaligned eyelashes;                                                                              
               (3)  placing punctal or lacrimal plugs;                                                                          
               (4)  diagnosing dilation and irrigation of                                                                       
     the lacrimal system;                                                                                                       
               (5)  performing orthokeratology;                                                                                 
               (6)  prescribing and fitting contact lenses                                                                      
     with the purpose of altering refractive error;                                                                             
               (7)  using diagnostic instruments that use                                                                       
     laser or ultrasound technology; and                                                                                        
               (8)  other similar procedures within the                                                                         
     scope and practice of optometry."                                                                                          
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
     Page 2, line 26, following "practice.":                                                                                  
          Insert "(a)"                                                                                                          
                                                                                                                                
     Page 2, following line 29:                                                                                                 
     Insert a new subsection to read:                                                                                           
     "(b)   A licensee  may not perform  ophthalmic surgery.                                                                    
     In  this  subsection,  "ophthalmic  surgery"  means  an                                                                    
     invasive procedure where human  tissue is cut, ablated,                                                                    
     or otherwise  penetrated by  incision, laser,  or other                                                                    
     means  to treat  diseases of  the human  eye, alter  or                                                                    
     correct refractive error, or  alter or enhance cosmetic                                                                    
     appearance; "ophthalmic  surgery" does not  include the                                                                    
     procedures described under AS 08.72.273."                                                                                  
                                                                                                                                
CHAIR KITO objected.                                                                                                            
                                                                                                                                
3:19:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON  described  Amendment  4  as  critical.                                                               
Qualifying  that he  is speaking  from memory,  he said  no fewer                                                               
than 20 optometrists  wrote him stating that HB 103  is not about                                                               
surgery,  but  rather about  controlling  their  own destiny  and                                                               
practice.   He explained Amendment 4  provides eight non-invasive                                                               
items that  can be done  by optometrists with  adequate training.                                                               
These would  be eight things  in the law that  optometrists don't                                                               
expressly have  now, he continued,  which would seem like  a good                                                               
thing if he were an optometrist.                                                                                                
                                                                                                                                
REPRESENTATIVE  JOSEPHSON said  Amendment  4  also clarifies  the                                                               
opinion of optometrists.   He recounted that  the committee heard                                                               
from a  doctor of optometry  in Juneau who  wanted to do  a large                                                               
number  of  surgeries.    There   is  some  confusion  about  the                                                               
motivation for the  optometrists, he continued.   In the original                                                               
bill,  optometrists wanted  to do  ophthalmic  surgery and  while                                                               
that is  not before the  committee, it  is important to  ask what                                                               
the motivation  or intent is.   He  said page 2,  subsection (b),                                                               
comes from  Washington state law  and delineates the  things that                                                               
optometrists are not  trained to do.  The  difference in training                                                               
is enormous  and that is why  the delineation should be  made, he                                                               
stated.  The [State Medical  Board] says an ophthalmologist needs                                                               
four  years from  an  accredited medical  school;  needs to  pass                                                               
steps  one, two,  and three  of general  medical boards;  needs a                                                               
year  of  internship  consisting  of  intensive  care,  emergency                                                               
medicine, surgery,  internal medicine, often in  80-100 hour work                                                               
weeks,  including  the  performance   of  thousands  of  surgical                                                               
procedures; needs a three-year  ophthalmic residency, which would                                                               
include laser  and ophthalmic surgeries under  close supervision;                                                               
needs  one to  two  years of  surgical  fellowship consisting  of                                                               
intensive  education;  and  that the  total  education  comprises                                                               
22,000 hours of work and  training.  [Ophthalmologists] also need                                                               
to complete an American Board  of Ophthalmology exam on a 10-year                                                               
renewable cycle;  need to have  mandatory 60 hours of  class, one                                                               
continuing  medical  education;  an annual  review;  and  license                                                               
renewal by the [State Medical Board].                                                                                           
                                                                                                                                
REPRESENTATIVE JOSEPHSON said he feels  that if the state doesn't                                                               
tightly  regulate surgical  eye care  there's really  no need  in                                                               
regulating  anything with  great  vigor.   While  that may  sound                                                               
alarmist,  he   continued,  he  feels   that  this   subject,  in                                                               
particular, needs  that sort of  scrutiny, and Amendment  4 would                                                               
essentially  mirror current  Washington state  practice.   If the                                                               
bill passes,  he pointed out, the  current law will say  that the                                                               
only  type of  invasive  surgery an  optometrist  can perform  is                                                               
removal  of a  foreign body  from the  eye, yet  the rest  of the                                                               
bill, CSHB 103(HSS), opens the door  for much more.  So, he said,                                                               
the bill already creates some  odd complications and he therefore                                                               
asks for support of Amendment 4.                                                                                                
                                                                                                                                
3:24:05 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KNOPP offered  his appreciation for Representative                                                               
Josephson's  concerns,  but  said  he has  always  advocated  for                                                               
allowing the  board to regulate  its profession within  the scope                                                               
of the  license, education,  training, and  experience -  that is                                                               
the key point.   He said Amendment 4 would gut  the intent of the                                                               
bill and therefore he is against  it.  According to the sectional                                                               
analysis, he  continued, Section  5 provides  that the  board may                                                               
not authorize  any procedure beyond  the scope of  the licensee's                                                               
education and  experience.  The  whole intent  of the bill  is to                                                               
allow optometrists to practice their  business in the manner that                                                               
they went to school  and were taught and trained to  do.  He said                                                               
he  cannot  see  them  doing  anything  outside  of  that  scope;                                                               
therefore, he is  speaking against Amendment 4 and  in support of                                                               
the bill.                                                                                                                       
                                                                                                                                
3:25:18 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD  recalled discussions  within the                                                               
Health  &  Social  Services   Standing  Committee  regarding  the                                                               
formation of the board  and the work of the board.   She said her                                                               
hope  is   that  additional  information   could  come   back  to                                                               
legislators in a year or two  that provides more detail about the                                                               
type of non-invasive procedures that  optometrists do.  She asked                                                               
whether this  is something the  sponsor thinks would  work better                                                               
than to try to amend the bill with this concept now.                                                                            
                                                                                                                                
REPRESENTATIVE SPOHNHOLZ  answered that, if the  bill passes, the                                                               
legislature's  role   is  to  ensure   that  the  law   is  being                                                               
implemented in  ways that the  legislature thinks  are consistent                                                               
with  its original  intent.    She added  that  having the  board                                                               
provide  presentations  on the  evolution  of  the board  process                                                               
seems like a reasonable thing to  do.  Regarding the amendment as                                                               
a  whole,  she  said  she   agrees  with  Representative  Knopp's                                                               
characterization that  it takes away the  guts of the bill.   The                                                               
intent  of  the bill  is  to  delegate  the authority  to  manage                                                               
optometrists  and the  practice  of optometry  to  the [Board  of                                                               
Examiners in Optometry].                                                                                                        
                                                                                                                                
REPRESENTATIVE  SPOHNHOLZ added  that she  doesn't disagree  with                                                               
Representative  Josephson's  characterization  of  the  extensive                                                               
education of  ophthalmologists who  are trained surgeons.   Using                                                               
an analogy, she noted that  the distinction between dentistry and                                                               
oral surgeons  is fairly similar    the amount of  education that                                                               
dentists receive  is fairly  similar to  the amount  of education                                                               
that optometrists receive.   Dentists oversee their  own scope of                                                               
practice through their board and  there are not huge problems and                                                               
conflicts between  oral surgeons  and dentists.   The  problem is                                                               
not  the distinction  between  optometry  and ophthalmology,  she                                                               
continued,  but rather  that the  legislature  is overseeing  it.                                                               
Taking politics  out of good  governance in health  programs, and                                                               
health practice in particular, is  the way get the best evidence-                                                               
based efforts and  management and that is why HB  103 proposes to                                                               
delegate that  authority as described specifically  to the [Board                                                               
of Examiners in Optometry].                                                                                                     
                                                                                                                                
3:28:30 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL stated he is  not able to list the procedures                                                               
that would be  performable by an optometrist and  doesn't want to                                                               
limit an optometrist's  practice just to that.  He  said the bill                                                               
would allow  the [Board  of Examiners in  Optometry] to  say what                                                               
optometrists  can  and  cannot  do  within  the  scope  of  their                                                               
training and practice.                                                                                                          
                                                                                                                                
REPRESENTATIVE WOOL  related that  over the  last week  he called                                                               
some optometrists in his home  community who hadn't called in and                                                               
were not following this in  committee and asked them whether they                                                               
wanted to  do surgery.  He  said their reply was  absolutely not.                                                               
One  optometrist, he  continued, told  him there  is a  procedure                                                               
that optometrists  are trained to  do, but  it cannot be  done in                                                               
Alaska and will  not be something optometrists will do  if HB 103                                                               
passes.   While  he respects  the argument  for 20,000  hours, he                                                               
said every medical doctor goes  through medical school whether to                                                               
be an ophthalmologist, heart surgeon,  or podiatrist, and much of                                                               
those 20,000  hours is studying  cardiology and cancer  and other                                                               
things, and  all those  hours are not  applicable exactly  to the                                                               
eye.   Optometrists spend  a lot  of hours  studying specifically                                                               
the eye, he continued, and they do  not want to do surgery out of                                                               
this bill; they just want to have control of their professions.                                                                 
                                                                                                                                
3:30:47 PM                                                                                                                    
                                                                                                                                
CHAIR KITO maintained his objection to Amendment 4.                                                                             
                                                                                                                                
A roll  call vote was  taken.  Representative Josephson  voted in                                                               
favor  of  Amendment  4.   Representatives  Wool,  Birch,  Knopp,                                                               
Sullivan-Leonard,  and   Kito  voted  against  it.     Therefore,                                                               
Amendment 4 failed to be adopted by a vote of 1-5.                                                                              
                                                                                                                                
3:31:18 PM                                                                                                                    
                                                                                                                                
CHAIR KITO announced that HB 103,  as amended, was now before the                                                               
committee.                                                                                                                      
                                                                                                                                
3:31:31 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON offered  comments  for the  legislative                                                               
record.   He recalled the  sponsor and  her aide as  both stating                                                               
that the bill does not touch AS  08.72.273.  The only way to read                                                               
that, he said, is to derive  the conclusion that the only type of                                                               
invasive surgery  that would be  allowed if this bill  became law                                                               
is removal  of a  foreign body.   This section  for removal  of a                                                               
foreign  body is  not intended  to permit  a licensee  to perform                                                               
invasive   surgery.     He   noted  that   Section   72  of   the                                                               
aforementioned  statute  covers  the entire  optometrists'  code.                                                               
So, he  continued, it  is not  just about  foreign bodies,  it is                                                               
about  all types  of  surgeries.   He  stated  that his  previous                                                               
amendment would  have helped optometrists by  saying that without                                                               
question those eight  things can be done, but now  there could be                                                               
a debate about that.                                                                                                            
                                                                                                                                
REPRESENTATIVE  JOSEPHSON added  that  this reminds  him in  some                                                               
ways about his response to SB  91, which he is mentioning because                                                               
he tends  to be cautious  about things  that can hurt  people and                                                               
things that  can hurt  the natural environment.   He  pointed out                                                               
that  the concerns  of the  ophthalmologists are  almost entirely                                                               
not economic.   Ophthalmologists have  spent their  lives working                                                               
in  eye  care  and  care  about  the  standard  of  practice,  he                                                               
continued, and while that is  not to say that optometrists don't,                                                               
the way  the bill is  written optometrists  can do any  manner of                                                               
things.   He  recollected that  in a  March 14  hearing before  a                                                               
different committee,  [Assistant Attorney General  Harriet] Milks                                                               
had  stated that  the  attorney general  would  not intervene  on                                                               
matters of  policy or  comment on  how the  optometrists regulate                                                               
themselves;  if they  are  promulgating  regulations within  this                                                               
bill,  they can  do it.   In  some respects,  this is  just being                                                               
moved to  a different  venue, he  said, and  people are  going to                                                               
continue reading about this in the newspaper.                                                                                   
                                                                                                                                
3:34:23 PM                                                                                                                    
                                                                                                                                
CHAIR  KITO  drew attention  to  Section  5  of the  bill,  which                                                               
states,  "A licensee  may perform  the services  of optometry  as                                                               
defined  in AS  08.72.300 only  if  the services  are within  the                                                               
scope of  the licensee's education,  training, and  experience as                                                               
established by regulations adopted by the  board."  He said he is                                                               
familiar  with this  type  of  thing because  he  is an  engineer                                                               
regulated under the [State Board  of Registration for Architects,                                                               
Engineers,  & Land  Surveyors].   As  an engineer,  he noted,  he                                                               
could theoretically  design a bridge, but  without any experience                                                               
designing a  bridge that bridge  could collapse and  hurt people.                                                               
With his  experience, he  continued, he  could design  a roadway,                                                               
breakwater, sewer,  or outfall, all of  which he has done  and in                                                               
which he has education, training, and  experience.  He said it is                                                               
his responsibility  within that  license to perform  those duties                                                               
that  he has  the training  for  and it  is  up to  him with  the                                                               
knowledge of  his education to  know when  and how to  apply that                                                               
experience.   Optometrists have much more  education and training                                                               
in their field  than he does in engineering, he  stated, and they                                                               
should be allowed to identify what  the scope of practice is that                                                               
is  consistent with  their experience,  education, and  training,                                                               
and he believes that  this bill goes there.  He  said he does not                                                               
believe  that  optometrists  will  be  practicing  outside  their                                                               
knowledge and experience and offered  his support for the passage                                                               
of HB 103.                                                                                                                      
                                                                                                                                
3:36:21 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL  moved to report  CSHB 103(HSS),  as amended,                                                               
out  of   committee  with  individual  recommendations   and  the                                                               
accompanying  fiscal  notes.   There  being  no  objection,  CSHB                                                               
103(L&C) was reported from the  House Labor and Commerce Standing                                                               
Committee.                                                                                                                      

Document Name Date/Time Subjects
HB124 Fiscal Note DCCED-CBPL 3.24.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 124
HB124 Sponsor Statement 3.22.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 124
HB036 Fiscal Note DOR-TAX 3.24.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 Sponsor Statement version I 2.28.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 Sectional Analysis version I 2.28.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 Brief Explanation of Changes ver J to ver I 2.28.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 Supporting Documents-Alaska Journal of Commerce Article 3.29.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 Supporting Documents-Current Oil Tax Apportionment 3.29.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 Supporting Documents-Legislative Research Report 04.131 Corp Taxation in AK 3.29.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 Supporting Documents-Side by Side Comparison Current Corporate Tax and HB 36 3.29.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 Supporting Documents-Taxes in Other States 3.29.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 version E 3.29.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 Brief explanation of changes version I to version E 3.29.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 Sectional Analysis version E 3.31.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 Sponsor Statement version E 3.29.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 36
HB036 Presentation-Sponsor 4.1.17.pptx HL&C 4/1/2017 1:00:00 PM
HB 36
HB124 Sectional Analysis 4.4.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 124
HB103 Supporting Documents-Letters of Opposition 4.1.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 103
HB103 Supporting Documents-Letters of Support 4.1.17.pdf HL&C 4/1/2017 1:00:00 PM
HB 103