Legislature(2015 - 2016)SENATE FINANCE 532

04/14/2016 08:00 AM Senate FINANCE

Note: the audio and video recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.

Download Mp3. <- Right click and save file as

* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= SB 130 TAX;CREDITS;INTEREST;REFUNDS;O & G TELECONFERENCED
Heard & Held
-- Public Testimony <Limited to 2 Minutes> --
Please arrive 15 minutes prior to the end of the
allotted time period or testimony will close
early. If you are a member of a group with the
same message, in the interest of time, please
select a spokesperson to testify for the group.
If you live in a community with an LIO, but are
unable to access it during the specified time
period, you may send written testimony to the
committee at: finance.committee@akleg.gov
+= HB 247 TAX;CREDITS;INTEREST;REFUNDS;O & G TELECONFERENCED
<Pending Referral>
+= HB 77 DISABILITY:ID/LICENSE AND TRAINING RQMTS. TELECONFERENCED
Moved CSHB 77(FIN) Out of Committee
+ HCR 4 US COUNTERMAND CONVENTION DELEGATES TELECONFERENCED
Moved CSHCR 4(STA) Out of Committee
+ SB 55 OPTOMETRY & OPTOMETRISTS TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled: TELECONFERENCED
+= HB 314 AK REG ECON ASSIST. PROGRAM; EXTEND TELECONFERENCED
Heard & Held
+= SB 206 REINSURANCE PROGRAM; HEALTH INS. WAIVERS TELECONFERENCED
Heard & Held
SENATE BILL NO. 55                                                                                                            
                                                                                                                                
     "An Act relating to the practice of optometry."                                                                            
                                                                                                                                
9:15:15 AM                                                                                                                    
                                                                                                                                
Co-Chair MacKinnon passed the gavel to Vice-Chair Micciche.                                                                     
                                                                                                                                
SENATOR CATHY GIESSEL, SPONSOR, introduced the legislation:                                                                     
                                                                                                                                
     This   bill   moves  the   continuing   education   (CE)                                                                   
     requirements  back into  regulation, as  desired  by the                                                                   
     Department   of   Commerce,   Community   and   Economic                                                                   
     Development. Continuing  education is still  required by                                                                   
     current  statute, but  the  hours and  subjects will  be                                                                   
     determined  by the  Board  of Optometry,  as with  other                                                                   
     professions.  The current  regulations  require more  CE                                                                   
     hours  than  the  statute  subsection  deleted  by  this                                                                   
     bill.                                                                                                                      
                                                                                                                                
     SB  55 allows  the board  to  determine prescribed  drug                                                                   
     schedules  anticipating  federal  regulations  that  may                                                                   
     change  again in the  future as they  did in  2014; that                                                                   
     regulation  required another  statute  change, and  this                                                                   
     bill  would allow  the board  to move  in step with  its                                                                   
     industry.                                                                                                                  
                                                                                                                                
     This bill  updates the  optometry definition  to reflect                                                                   
     current   education  and   training,  but   specifically                                                                   
     prohibits invasive  surgery. This allows  for future new                                                                   
     and improved  diagnostic  and therapeutic procedures  as                                                                   
     determined by  the board, while not having  to return to                                                                   
     the  legislature for  every  new technological  advance.                                                                   
     It  also defines  that  optometrists  must be  qualified                                                                   
     for any procedure that they perform.                                                                                       
                                                                                                                                
     This  bill  also  further   defines  and  clarifies  the                                                                   
     prohibited  surgical   procedures  under   an  "invasive                                                                   
     surgery"  definition.  Alaska  optometrists  already  do                                                                   
     superficial  surgical  procedures  such  as  removal  of                                                                   
     corneal  foreign  bodies   under  current  statute,  but                                                                   
     nothing invasive would be allowed.                                                                                         
                                                                                                                                
9:24:31 AM                                                                                                                    
                                                                                                                                
Senator  Bishop  thought the  bill's  purpose  was clear.  He                                                                   
referred to  the bill allowing  "new and improved  diagnostic                                                                   
and therapeutic  procedures." He wondered whether  that was a                                                                   
"catch all"  or would there  be additional efforts  to assist                                                                   
the optometrist.                                                                                                                
                                                                                                                                
Senator Giessel deferred to an optometrist.                                                                                     
                                                                                                                                
9:25:53 AM                                                                                                                    
                                                                                                                                
JANE CONWAY, STAFF, SENATOR CATHY GIESSEL, discussed the                                                                        
sectional analysis (copy on file):                                                                                              
                                                                                                                                
     1. Section 1                                                                                                               
                                                                                                                                
     Amends 08.72.050  Regulations. Adds to this  section the                                                                   
     power for  the board to  adopt regulations  allowing the                                                                   
     prescription   and   pharmaceutical   agents   for   the                                                                   
     treatment of  eye disease and also that  under agreement                                                                   
     with  the State  Medical  Board,  it will  describe  the                                                                   
     scope of practice  for a licensee to  perform ophthalmic                                                                   
     surgery and noninvasive procedures.                                                                                        
                                                                                                                                
     2. Section 2.                                                                                                              
                                                                                                                                
     Amends 08.72.181  (d) by  requiring specified  hours and                                                                   
     period  of  continuing education  requirements  for  the                                                                   
     renewal   of  an  optometrist's   license  but   retains                                                                   
     delegation  of  those  requirements   to  the  board  in                                                                   
     regulation.                                                                                                                
                                                                                                                                
     3. Section 3.                                                                                                              
                                                                                                                                
     Repeals  and reenacts  AS 08.72.272(a)  to provide  that                                                                   
     pharmaceutical     agents,      including     controlled                                                                   
     substances,  may be  used by a  licensed optometrist  if                                                                   
     consistent with  standards adopted by the  board and any                                                                   
     limitations on practice under section 5 of the bill.                                                                       
                                                                                                                                
     4. Section 4.                                                                                                              
                                                                                                                                
     08.72.272  amends and adds  new subsections  prohibiting                                                                   
     an  optometrist  to  make  injections  into  the  ocular                                                                   
     globe  of  the  eye  and limits  the  prescribing  of  a                                                                   
     controlled  substance in  a quantity  exceeding a  7-day                                                                   
     supply  and  requires  a  referral  to  a  physician  or                                                                   
    ophthalmologist if a longer prescription is needed.                                                                         
                                                                                                                                
     5. Section 5.                                                                                                              
                                                                                                                                
     08.72 is  amended and a  new section is  added 08.72.278                                                                   
     Limitation  on Practice.  Provides that  a licensee  may                                                                   
     perform only  services within the licensee's  education,                                                                   
     training   and   experience   as   provided   by   board                                                                   
     regulation.                                                                                                                
                                                                                                                                
     6. Section 6                                                                                                               
                                                                                                                                
     08.72.300(3) revises the definition of optometry.                                                                          
                                                                                                                                
9:28:17 AM                                                                                                                    
                                                                                                                                
JILL MATHESON,  ALASKA OPTOMETRIC  ASSOCIATION, testified  in                                                                   
support of the bill.                                                                                                            
                                                                                                                                
Senator Bishop asked Ms. Matheson to restate her concern.                                                                       
                                                                                                                                
Ms. Matheson replied at Section 1, line 6.                                                                                      
                                                                                                                                
Senator  Olson  asked  if  Ms.   Matheson  had  been  on  the                                                                   
Optometry Board.                                                                                                                
                                                                                                                                
Ms. Matheson  stated she  was on the  board for  eight years,                                                                   
and in that time there had been no complaints.                                                                                  
                                                                                                                                
Senator  Olson  asked  how  the bill  changed  the  scope  of                                                                   
practice for optometrists.                                                                                                      
                                                                                                                                
Ms. Matheson  thought the  bill allowed  for optometrists  to                                                                   
provide for patients at the highest level of care.                                                                              
                                                                                                                                
Senator Olson  asked if  Ms. Matheson  had ever practiced  in                                                                   
rural Alaska.                                                                                                                   
                                                                                                                                
Ms. Matheson replied in the negative.                                                                                           
                                                                                                                                
9:35:10 AM                                                                                                                    
                                                                                                                                
JEFF   GONNASON,   LEGISLATIVE    CHAIR,   ALASKA   OPTOMETRY                                                                   
ASSOCIATION  (via teleconference),  testified  in support  of                                                                   
the bill.                                                                                                                       
                                                                                                                                
Senator  Olson  wondered  if there  were  any  other  trained                                                                   
professions that were classified under two boards.                                                                              
                                                                                                                                
Mr. Gonnason replied in the negative.                                                                                           
                                                                                                                                
9:40:24 AM                                                                                                                    
                                                                                                                                
Senator  Olson   wondered  if  there  were   any  significant                                                                   
changes in training.                                                                                                            
                                                                                                                                
Mr.  Gonnason relayed  that medicine,  dentistry,  optometry,                                                                   
and  health  care  had  expanded greatly  in  ten  to  twenty                                                                   
years. There were new drugs and procedures.                                                                                     
                                                                                                                                
9:41:39 AM                                                                                                                    
                                                                                                                                
DR.  PAUL BARNEY,  CHAIRMAN,  BOARD OF  OPTOMETRY,  ANCHORAGE                                                                   
(via teleconference),  testified in  support of the  bill. He                                                                   
thought the CS  for SB 55 (L&C) was excellently  written with                                                                   
the exception  of the aforementioned language  specifying the                                                                   
State Medical  Board. He  urged the  committee to  strike the                                                                   
State Medical Board language from the bill.                                                                                     
                                                                                                                                
9:46:22 AM                                                                                                                    
                                                                                                                                
DR.    CARL    ROSEN,    OPTHAMOLOGIST,     ANCHORAGE    (via                                                                   
teleconference),  testified  in opposition  to  the bill.  He                                                                   
discussed primary  eye care, which  was part of  his purview.                                                                   
He thought  the bill  was a  big pivot  point for  optometry,                                                                   
and  urged caution.  He  thought it  was  important that  the                                                                   
State Medical Board was involved.                                                                                               
                                                                                                                                
Senator  Olson  thanked  Dr.  Rosen  for  practicing  in  the                                                                   
state. He  asked if Dr.  Rosen had ever  been on  the medical                                                                   
board. He  shared that  he had never  been an elected  member                                                                   
of  the medical  board. Dr.  Rosen replied  in the  negative,                                                                   
but  he  had  worked closely  with  someone  on  the  medical                                                                   
board.                                                                                                                          
                                                                                                                                
Senator  Olson  asked if  Dr.  Rosen  was familiar  with  the                                                                   
training for  optometrists. Dr.  Rosen recounted that  he had                                                                   
visited an optometry  school, and was boycotted.  He stressed                                                                   
that  ophthalmology   was  a   select  sub-specialty   within                                                                   
medicine.                                                                                                                       
                                                                                                                                
9:52:47 AM                                                                                                                    
                                                                                                                                
Senator  Olson  asked if  Dr.  Rosen  had ever  practiced  in                                                                   
rural Alaska. Dr. Rosen replied in the negative.                                                                                
                                                                                                                                
Senator Olson  wondered if  the ophthalmologists  were behind                                                                   
the negative media advertisements.                                                                                              
                                                                                                                                
Mr. Rosen  stressed that  it was an  onerous task  to testify                                                                   
about  this  issue.  He  remarked  that  optometrists  should                                                                   
become  ophthalmologists,  should they  want  to achieve  the                                                                   
proposals laid out in the legislation.                                                                                          
                                                                                                                                
Senator  Olson commented  that  he was  somewhat offended  by                                                                   
the advertisements.                                                                                                             
                                                                                                                                
9:55:18 AM                                                                                                                    
                                                                                                                                
Senator Dunleavy  asked for an  explanation of what  the bill                                                                   
would  allow or  not allow  optometrists  to do  in terms  of                                                                   
surgery.                                                                                                                        
                                                                                                                                
Senator  Giessel stated  that there  were invasive  surgeries                                                                   
that ophthalmologists did on the eye that were prohibited.                                                                      
                                                                                                                                
Senator  Dunleavy asked  about the  surface of  the eye,  and                                                                   
procedures such  as Lasik surgery  or cataracts.  He wondered                                                                   
what medical professionals currently performed the surgery.                                                                     
                                                                                                                                
Senator Giessel  believed that Lasik and  cataracts surgeries                                                                   
were not performed by optometrists.                                                                                             
                                                                                                                                
10:00:40 AM                                                                                                                   
                                                                                                                                
Vice-Chair  Micciche referred  to  Section 4  and Section  5,                                                                   
which discussed the limitations of optometry practice.                                                                          
                                                                                                                                
Senator Bishop  felt that  there could be  a referral  for an                                                                   
emergency procedure.                                                                                                            
                                                                                                                                
Senator   Giessel  thought   that  certainly   a  fish   hook                                                                   
penetrating  the globe  of the  eye in to  the vitreous,  and                                                                   
remarked  there  would probably  be  a referral.  She  shared                                                                   
that telehealth was currently expanding.                                                                                        
                                                                                                                                
10:04:02 AM                                                                                                                   
                                                                                                                                
Vice-Chair Micciche CLOSED public testimony.                                                                                    
                                                                                                                                
Senator  Olson asked  about medical  professionals that  were                                                                   
governed by two boards.                                                                                                         
                                                                                                                                
SARA CHAMBERS,  ADMINISTRATIVE  OPERATIONS MANAGER,  DIVISION                                                                   
OF  CORPORATIONS,   BUSINESS   AND  PROFESSIONAL   LICENSING,                                                                   
DEPARTMENT OF  COMMERCE, COMMUNITY AND ECONOMIC  DEVELOPMENT,                                                                   
stated that the current model was not like any other model.                                                                     
                                                                                                                                
Senator Olson wondered  whether the medical board  could take                                                                   
action against the licensee.                                                                                                    
                                                                                                                                
Ms.  Chambers  looked  at  page   1,  line  12,  which  posed                                                                   
logistical  concerns.  She  noted that  because  AS  08.08.64                                                                   
were not amended,  there was not requirement  for the medical                                                                   
board  to  enter   into  an  agreement  with   the  Board  of                                                                   
Examiners  in  Optometry.  She  felt  that  there  were  some                                                                   
logistical  concerns that  would  stymie the  efforts of  the                                                                   
bill.                                                                                                                           
                                                                                                                                
Senator  Olson   wondered  whether  the  department   was  in                                                                   
support of the current version of the bill.                                                                                     
                                                                                                                                
Ms.  Chambers replied  that  the department  did  not have  a                                                                   
position on  the bill. There  was concern with  the logistics                                                                   
and   operations.   There   were   conversations   with   the                                                                   
Department of Law.                                                                                                              
                                                                                                                                
Senator Olson agreed with that concern.                                                                                         
                                                                                                                                
Senator Dunleavy  asked why  the department  had not  taken a                                                                   
position on the bill.                                                                                                           
                                                                                                                                
Ms. Chambers stated  that when there was a  clear desire from                                                                   
one board  to accomplish  a goal, the  department may  take a                                                                   
position to support  the board. She remarked  that there were                                                                   
two  entities  involved  in support  and  opposition  to  the                                                                   
bill, so the department would not take a position.                                                                              
                                                                                                                                
10:08:02 AM                                                                                                                   
                                                                                                                                
Senator Dunleavy  thought it made  sense that  the department                                                                   
should  take a  position, when  the  issue was  related to  a                                                                   
life or  death situation. He  wondered if the  bill contained                                                                   
anything  dangerous. He  assumed that  not taking a  position                                                                   
indicated no problem with the bill.                                                                                             
                                                                                                                                
Senator Olson  replied that  the department  was not  full of                                                                   
trained medical professionals.                                                                                                  
                                                                                                                                
Senator  Dunleavy  thought the  bills  he had  sponsored  had                                                                   
garnered  opinions from  those who  were not  experts in  the                                                                   
field.                                                                                                                          
                                                                                                                                
Vice-Chair Micciche  thought it was specifically  a "Dunleavy                                                                   
problem."                                                                                                                       
                                                                                                                                
10:09:58 AM                                                                                                                   
                                                                                                                                
Senator Olson MOVED to ADOPT Amendment 1:                                                                                       
                                                                                                                                
     Page 1, line 12:                                                                                                           
                                                                                                                                
          Delete "by agreement with the State Medical                                                                           
          Board."                                                                                                               
                                                                                                                                
Vice-Chair Micciche OBJECTED for discussion.                                                                                    
                                                                                                                                
Senator Olson explained the amendment. He felt that                                                                             
optometrists should not be overseen by two boards.                                                                              
                                                                                                                                
Co-Chair Kelly asked the sponsor's opinion on the                                                                               
amendment.                                                                                                                      
                                                                                                                                
Senator Giessel expressed her support for the amendment.                                                                        
                                                                                                                                
Vice-Chair Micciche removed his objection.  There being NO                                                                      
OBJECTION, Amendment 1 was ADOPTED.                                                                                             
                                                                                                                                
Vice-Chair Micciche stated that the committee would hold                                                                        
the bill.  He discussed the afternoon schedule.                                                                                 
                                                                                                                                
SB 55 was HEARD and HELD in committee for further                                                                               
consideration.                                                                                                                  
                                                                                                                                

Document Name Date/Time Subjects
HB 77 CSHB 77 Sponsor Statement 3 11 16.pdf SFIN 4/14/2016 8:00:00 AM
HB 77
HB 77 Disability Training and Identification Bill support senator mackinnon.docx SFIN 4/14/2016 8:00:00 AM
HB 77
HB 77- Supporting Documentation.pdf SFIN 4/14/2016 8:00:00 AM
HB 77
HB 77 Summary of Changes ver. W-ver. E-, ver. P 4-5-2016.pdf SFIN 4/14/2016 8:00:00 AM
HB 77
HCR 4 Support Document - Article V text.pdf SFIN 4/14/2016 8:00:00 AM
HCR 4
HCR4 Sectional Analysis.pdf SFIN 4/14/2016 8:00:00 AM
HCR 4
HCR4 Sponsor Statement.pdf SFIN 4/14/2016 8:00:00 AM
HCR 4
HCR4 Support Document - emails.pdf SFIN 4/14/2016 8:00:00 AM
HCR 4
HCR4 Support Document, Louisiana.pdf SFIN 4/14/2016 8:00:00 AM
HCR 4
HCR4 Support Document, New Mexico Rep. Herrell.pdf SFIN 4/14/2016 8:00:00 AM
HCR 4
HCR4 Support Document, North Dakota Rep. Fehr.pdf SFIN 4/14/2016 8:00:00 AM
HCR 4
SB 55 Sponsor Statement vsn I.pdf SFIN 4/14/2016 8:00:00 AM
SB 55
SB 55 CSSB 55(LC) Sectional Analysis 4-12-16.pdf SFIN 4/14/2016 8:00:00 AM
SB 55
SB 55 Amendment 1 Olson.pdf SFIN 4/14/2016 8:00:00 AM
SB 55