Legislature(2001 - 2002)

02/14/2002 01:37 PM Senate L&C

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
              SB 270-BOARD OF DISPENSING OPTICIANS                                                                          
                                                                                                                                
CHAIRMAN STEVENS announced SB 270 to be up for consideration.                                                                   
                                                                                                                                
MS. HEATHER  BRAKES, Staff  to Senator  Therriault, sponsor  of SB
270, said that there was a committee substitute.                                                                                
                                                                                                                                
SENATOR AUSTERMAN moved  to adopt the CS to SB 270.  There were no                                                              
objections and it was so ordered.                                                                                               
                                                                                                                                
MS. BRAKES  said that SB  270 was based  on an audit  conducted by                                                              
the Legislative Audit  Division and it had several  concerns about                                                              
the Board  of Dispensing Opticians.  One of them was  addressed in                                                              
recommendation #1 on page 7 of the audit.                                                                                       
                                                                                                                                
     The auditors  felt the disparity  between the  number of                                                                   
     people  who become  licensed  and the  number of  people                                                                   
     registering to be apprentices  suggests that 6,000 hours                                                                   
     of  required apprenticeship  may  be unduly  prohibiting                                                                   
     people from  being licensed. The auditor  suggested that                                                                   
     the  board   reconsider  the  necessity  of   the  6,000                                                                   
     requirement.                                                                                                               
                                                                                                                                
The  board's response  agrees with  the auditor's  recommendation,                                                              
but they  want to  add an additional  $800 correspondence  course.                                                              
The course  is not  included in  the legislation.  The feeling  is                                                              
that it would  be a hardship to  the employee and the  expense may                                                              
be shifted to the employer.                                                                                                     
                                                                                                                                
     Recommendation #2 addresses  the board's state exam. The                                                                   
     95 sunset review recommended  that the board improve the                                                                   
     objectivity and  consistency of the state's  exam. After                                                                   
     finding,  again,  that  the  board's  exam  process  was                                                                   
     flawed in  several of the  cases selected for  review by                                                                   
     the auditors,  the auditor suggests that the  board give                                                                   
     serious  consideration  to discontinuing  the  practical                                                                   
     exam and require applicants  only to pass the nationally                                                                   
     recognized  exams  offered.  Those  national  exams  are                                                                   
     incorporated  in SB  270. The  auditor  continues to  be                                                                   
     concerned  about the  apparent  subjectivity and  error-                                                                   
     prone nature of the exam.                                                                                                  
                                                                                                                                
MS. BRAKES  said the  section 1  extends the  Board of  Dispensing                                                              
Opticians for three  years to June 30, 2005 as  recommended by the                                                              
audit  report released  on January  24. Sections  2,3,4,6,8 and  9                                                              
remove  the  board's  state examination.  Section  5  reduces  the                                                              
number of apprenticeship hours to  3,000 hours. It also allows for                                                              
an applicant who has earned an associate  degree from a recognized                                                              
school  or  college  of  dispensing  opticians  to  use  it  as  a                                                              
substituted in lieu of any apprenticeship hours.                                                                                
                                                                                                                                
TAPE 02-5, SIDE B                                                                                                             
                                                                                                                                
MS. PAT DAVIDSON,  Legislative Auditor, said that  she recommended                                                              
only a  three-year extension  until 2005  rather than the  typical                                                              
four-year extension.  Her reasoning is discussed  in the Auditor's                                                              
Comments where they  looked at alternative methods  to achieve the                                                              
purpose of  the program. This looked  like one where  making those                                                              
changes - moving  to a national exam, reducing  the apprenticeship                                                              
hours  -  could  be  handled  by   the  Division  of  Occupational                                                              
Licensing  under   the  registration  process  rather   than  full                                                              
licensing under a board process.  They wanted to see how the board                                                              
dealt with  the recommendations  in  the report  and come back  in                                                              
three years  and see  if it appeared  to still  be a good  idea to                                                              
take it to a registration process.                                                                                              
                                                                                                                                
SENATOR AUSTERMAN asked how many states have boards.                                                                            
                                                                                                                                
MS.  DAVIDSON replied  she  thought  22 states  currently  license                                                              
dispensing opticians. The other states  either have a registration                                                              
process  or no  registration or  licensing. In  looking at  those,                                                              
scope of practice seemed to be one of the key things.                                                                           
                                                                                                                                
     In  other  states, these  type  of activities  may  have                                                                   
     required  supervision  by either  an  optometrist or  an                                                                   
     ophthalmologist.  In  this state  having  a license  for                                                                   
     dispensing optician allows them  to establish a practice                                                                   
     without  supervision  of  either   of  those  two  other                                                                   
     professions.                                                                                                               
                                                                                                                                
SENATOR TORGERSON asked if the bill  covered her concerns as shown                                                              
in the audit.                                                                                                                   
                                                                                                                                
MS. DAVIDSON replied that it does.                                                                                              
                                                                                                                                
SENATOR  AUSTERMAN  asked  if  the  legislature  was  supposed  to                                                              
discuss  about whether  they need  the licensing  board or  not in                                                              
2005.                                                                                                                           
                                                                                                                                
MS. DAVIDSON  replied that there  are automatic sunset  audits for                                                              
these boards.  They would come back  in three years and  the focus                                                              
of the  audit at  that time would  be an  evaluation of  whether a                                                              
licensing board is  still required or whether it  can simply go to                                                              
a registration process.                                                                                                         
                                                                                                                                
SENATOR  AUSTERMAN  asked  if  the   number  of  states  having  a                                                              
licensing board was  increasing. He wanted to know  what the trend                                                              
was.                                                                                                                            
                                                                                                                                
MS. DAVIDSON  said she  didn't have that  information. There  is a                                                              
national professional  organization with a website  which is where                                                              
they can get that kind of information.  She reiterated that, "Part                                                              
of the interplay  with this profession has to do  with those other                                                              
professions  that  are  closely   associated  with  this  type  of                                                              
practice. Those being the opticians and the ophthalmologists."                                                                  
                                                                                                                                
CHAIRMAN STEVENS asked if the substitution  of an associate degree                                                              
was  acceptable for  the auditors  in  place of  the actual  hours                                                              
training.                                                                                                                       
                                                                                                                                
MS. DAVIDSON  said currently  if  a person has  no more  education                                                              
beyond high  school, 6,000  hours of  apprenticeship is  required.                                                              
That is  reduced to 2,000  hours if one  has an associate  degree.                                                              
The recommendation says if you're  only relying on your experience                                                              
for qualification to reduce the hours  from 6,000 to 3,000; but if                                                              
you have a degree, your apprenticeship is waived.                                                                               
                                                                                                                                
SENATOR TORGERSON  pointed out that  it is odd  to say one  of the                                                              
qualifications is to  have attended a high school  for four years.                                                              
He thought they would want a person to have graduated.                                                                          
                                                                                                                                
MS. DAVIDSON responded that was an excellent point.                                                                             
                                                                                                                                
2:35 p.m.                                                                                                                       
                                                                                                                                
MR. LARRY HARPER,  a dispensing optician, said  he represented the                                                              
State  Board  of  Dispensing  Opticians,   National  Contact  Lens                                                              
Examiners and the  Opticians Association of Alaska.  He noted that                                                              
he had just received their working draft. He said:                                                                              
                                                                                                                                
     One of the  reasons that the audit was so  damning to us                                                                   
     in regards  to the testing  procedures was when  we look                                                                   
     back at  our past  fail rate,  and that's important  not                                                                   
     only here in  the state, but on a national  basis, we're                                                                   
     finding that people who are  coming to take this exam at                                                                   
     the end of  their 6,000 hours are doing a  miserable job                                                                   
     of passing  this national written  exam. The  reason for                                                                   
     asking  for the  home  study  course was  to  put in  an                                                                   
     educational component. The way  this course works is two                                                                   
     fold.   It   really   develops   and   cleans   up   the                                                                   
     apprenticeship  program, of  which  the guidelines  have                                                                   
     been incredibly lax, and puts  the apprentice himself in                                                                   
     contact with  a sponsor in the  Lower 48 who is  also in                                                                   
     touch with  their sponsor on  the job. So they  learn in                                                                   
     an  sequential manner.  This  program  has been  trouble                                                                   
     shot over the past 20 years  and reducing the hours from                                                                   
     6,000 to 3,000  makes no sense. If we can't  bring these                                                                   
     people to the  test table and have them prepared  at the                                                                   
     end of 6,000  hours, how are we possibly going  to do it                                                                   
     in  3,000 if  we don't  clean up  the training  program:                                                                   
     It's imperative  that the  training program be  included                                                                   
     in this  scenario in order  to prepare these  people for                                                                   
     success.                                                                                                                   
                                                                                                                                
MR. HARPER said the Board has found  a source for a professionally                                                              
written  practical examination.  His  experience  on the  National                                                              
Contact Lens  Examiners Board and  the Board of  Optitionery shows                                                              
that the  national written  test  was never designed  as a  stand-                                                              
alone  competency  exam for  optitionery.  It  is an  entry  level                                                              
certification exam  so someone entering  the field has an  idea of                                                              
what it's all  about. He concluded that the  educational component                                                              
was necessary if the hours were reduced to 3,000.                                                                               
                                                                                                                                
The   other  concerns   of  the   legislative   audit  are   being                                                              
aggressively pursued, he said.                                                                                                  
                                                                                                                                
SENATOR TORGESRON asked  if he was in favor of  dropping the hours                                                              
to 3,000.                                                                                                                       
                                                                                                                                
MR.  HARPER replied  that he  is  not in  favor of  it unless  the                                                              
educational  component becomes a  part of  the equation.  "We just                                                              
are not seeing the success at the  testing table that we should be                                                              
seeing."                                                                                                                        
                                                                                                                                
SENATOR TORGERSON asked if the education  component was on-the-job                                                              
training.                                                                                                                       
                                                                                                                                
MR. HARPER replied,  "As with all on-the-job training,  it depends                                                              
greatly  on the instructor  as to  how successful  the trainee  is                                                              
going to be…."                                                                                                                  
                                                                                                                                
SENATOR  AUSTERMAN  said  he  has  some  concerns  with  exempting                                                              
employees that isn't dealt with in the bill.                                                                                    
                                                                                                                                
MS.  CATHERINE   REARDON,  Director,   Division  of   Occupational                                                              
Licensing, said her  division staffs both the  Board of Dispensing                                                              
Opticians  and  the  Optometry  Board.  She said  that  there  are                                                              
ophthalmologists  who  are MD  physicians  who specialize  in  eye                                                              
care; then there's optometrists and opticians.                                                                                  
                                                                                                                                
     In the past, there has been  a difference in perspective                                                                   
     between  the  Board  of  Dispensing  Opticians  and  the                                                                   
     Optometry   Board   over  whether   the   employees   of                                                                   
     optometrists  who  do dispensing  optician  work  should                                                                   
     have to be licensed as dispensing  opticians or optician                                                                   
     apprentices.  This  came up  at  the  time of  the  last                                                                   
     extensions  for both boards  four or  six years ago.  It                                                                   
     has been  an issue of  contention for longer  than that.                                                                   
     My  summary   is  I  have   the  impression   that  some                                                                   
     optometrists have  raised this issue in the  last day or                                                                   
     so  - expressing  the  desire  to have  their  employees                                                                   
     exempted from the dispensing optician statute.                                                                             
                                                                                                                                
     My  brief  summary of  what  I  think the  arguments  on                                                                   
     either  side  are is  that  the optometrists  feel  like                                                                   
     since  they are  supervising their  employees work  that                                                                   
     they can provide the necessary  public health and safety                                                                   
     protection  insuring  that  their  employees  are  doing                                                                   
     adequate  dispensing optician work.  So they don't  need                                                                   
     to be licensed. Mr. Harper is  here, so he could correct                                                                   
     me, but my  impression is that the Dispensing  Opticians                                                                   
     Board   has  felt   that  it   is   necessary  to   have                                                                   
     demonstrated  the  skills and  knowledge  of  dispensing                                                                   
     optitionery,  which  are proven  through  the  licensing                                                                   
     process in order to safely provide those skills to the                                                                     
     public.                                                                                                                    
                                                                                                                                
CHAIRMAN  STEVENS  asked  how  long   is  a  typically  dispensing                                                              
optician apprenticeship before they decide to sit for a license.                                                                
                                                                                                                                
MS. REARDON replied  that some of the apprentices  choose never to                                                              
sit for the exam.  They come to the end of the  six years and move                                                              
on to a different occupation. A dispensing  optician apprentice is                                                              
not highly paid;  so some people are not going into  those jobs as                                                              
a career. They are apprentices for training.                                                                                    
                                                                                                                                
CHAIRMAN  STEVENS calculated  that  it would  take  a little  over                                                              
three years  to hit 6,000  (5,076) hours  given a 240  day working                                                              
year at  eight hours  a day; 2,000  hours would  be less  than one                                                              
year. So  he thought it  would take a little  less than one  and a                                                              
half years to meet the 3,000-hour obligation.                                                                                   
                                                                                                                                
He asked  Mr. Harper why  they wanted  to require the  home school                                                              
course when  it seems like  the individuals  would get a  lot more                                                              
hands-on  instruction with  the 3,000 hours  under a  professional                                                              
instead of an instructor. He didn't  understand the justification,                                                              
because  the  person  in  the  apprenticeship   gets  a  lot  more                                                              
instruction.                                                                                                                    
                                                                                                                                
MR. HARPER replied that in almost  every situation when someone is                                                              
in  an  apprenticeship  program,   they  are  doing  other  things                                                              
throughout the course of an 8-hour  day that doesn't fall anywhere                                                              
close  to  the  realm  of  training. That  is  why  time  for  the                                                              
educational component  is so important. An AA degree  has the work                                                              
component  within it, because  they all  have dispensaries  within                                                              
the schools. Plus they are getting  8 hours of instruction without                                                              
interruptions  for  doing  other  unassociated  things.  A  degree                                                              
program is  much more intensive course  work and covers  a broader                                                              
curriculum than the apprenticeship program.                                                                                     
                                                                                                                                
CHAIRMAN  STEVENS  asked if  he  was  speaking  for the  Board  or                                                              
individually. He asked  what the Board's position  was on removing                                                              
the state requirement for examination.                                                                                          
                                                                                                                                
He replied  that he  is speaking  individually.  The Board  is not                                                              
interested  at   all  in  removing   the  state   requirement  for                                                              
examination.  "That's  coming from  Budget  and  Audit. The  State                                                              
Board's position as  reflected in the minutes of  our last meeting                                                              
are very very specific."                                                                                                        
                                                                                                                                
CHAIRMAN STEVENS said that the correspondence  curriculum would be                                                              
geared towards a national test not for a state test.                                                                            
                                                                                                                                
MR. HARPER replied  that wasn't correct. He said  the program they                                                              
found is as good as anyone could  find in a home study program. It                                                              
goes far  beyond the  national competency exam,  which is  not for                                                              
licensing.                                                                                                                      
                                                                                                                                
CHAIRMAN  STEVENS asked  if the  National Board  of Opticians  has                                                              
national standards.                                                                                                             
                                                                                                                                
MR.  HARPER  said  he  is  a  past   president  of  the  Opticians                                                              
Association  of America  and  that  there is  a  lot of  different                                                              
components to what  they do, but how to apply that  on the day-to-                                                              
day work station  and deliver the best in optics  to the public is                                                              
what the second component focuses on.                                                                                           
                                                                                                                                
     We want  these people prepared  for success and  we want                                                                   
     the  very  best for  the  population  for the  State  of                                                                   
     Alaska. This  is a very  good public health  program and                                                                   
     we  need more of  them. This  doesn't cost  the state  a                                                                   
     dime…"                                                                                                                     
                                                                                                                                
CHAIRMAN  STEVENS  asked  how many  people  begin  as  apprentices                                                              
actually sit for a license.                                                                                                     
                                                                                                                                
MS. REARDON replied eight.                                                                                                      
                                                                                                                                
MR. HARPER said  they have reviewed the results and  are not happy                                                              
with them. "There  has been a 10-year lapse and we  feel that this                                                              
board has a lot of work to do."                                                                                                 
                                                                                                                                
MS. DAVIDSON  said on page  13 of the  Audit Report  they identify                                                              
the number  of apprenticeships by  fiscal year for the  last three                                                              
years as  well as  the number  of licenses  issued for  dispensing                                                              
opticians.                                                                                                                      
                                                                                                                                
     You'll see a significant difference  in those numbers. I                                                                   
     would  add  that  it  does   appear,  just  given  those                                                                   
     numbers,  that as  Ms. Reardon  spoke  to, not  everyone                                                                   
     working for a  dispensing optician has the  goal of that                                                                   
     as their profession  in mind. When there's  a discussion                                                                   
     about  apprentices  taking   that  course,  the  concern                                                                   
     becomes is it reasonable for  people who are not looking                                                                   
     for  licensure as  a dispensing optician  to go  through                                                                   
     that expense.  If you are  trying to raise  your passage                                                                   
     rate  and it's a  good idea,  then it's  a good idea.  I                                                                   
     don't know that  the state wants to create  that type of                                                                   
     requirement.  If  they are  not  prepared to  pass  that                                                                   
     national test, then they won't.                                                                                            
                                                                                                                                
     Our  concern with  the audit  is the  problems with  the                                                                   
     practical exam. It was a problem  six years ago and it's                                                                   
     a  continuing  problem.  Being  a  problem  when  you're                                                                   
     dealing  with  a  licensing   function  is  that  you're                                                                   
     putting barriers  of entry into the profession  in front                                                                   
     of  individuals and  that's  what we  see  as the  major                                                                   
     problem  and those  have to  go away.  I understand  the                                                                   
     Board  may want to  set those  standards high enough  to                                                                   
     protect the public, but they  cannot be as subjective as                                                                   
     they are right now, because it causes more problems.                                                                       
                                                                                                                                
CHAIRMAN   STEVENS  asked   if  a   prior  audit   had  the   same                                                              
recommendations.                                                                                                                
                                                                                                                                
MS. DAVIDSON  replied that  their prior audit  six years  ago also                                                              
identified problems with the practical  exam given by the Board in                                                              
terms of  its error-prone  nature and its  lack of real  objective                                                              
criteria.                                                                                                                       
                                                                                                                                
MR. HARPER  said he  couldn't agree with  Ms. Davidson  more. "The                                                              
strange truth of the matter is that  opticians are not necessarily                                                              
qualified to be professional test  writers. Therefore, they did an                                                              
RFP  and have  found a  good test  and would  like to  give it  in                                                              
April. There  is no cost to  the state; there's no  increased cost                                                              
to the test takers.                                                                                                             
                                                                                                                                
     All  it does  is give  them  a professionally  qualified                                                                   
     exam…. Both the  chairman and I have taken  the exam. It                                                                   
     is absolutely straight-forward.  There is no guess work;                                                                   
     there is no subjectivity - just  yes or no. There's only                                                                   
     one answer.                                                                                                                
                                                                                                                                
CHAIRMAN STEVENS asked  if he had a position on  exempting certain                                                              
employees from statute.                                                                                                         
                                                                                                                                
MR. HARPER replied that has been  an on-going topic of discussion.                                                              
The position  of the Optician's Board  is this, "If you  are going                                                              
to make independent  optician decisions having to  do with patient                                                              
care,  then you  need  to be  a  licensed dispensing  optician  or                                                              
working under someone's direct supervision."                                                                                    
                                                                                                                                
If someone  wants to be  a frame stylist  or whatever,  they don't                                                              
have  a  problem  with  that.  He   said  that  there  are  a  few                                                              
optometrists who don't like the fact  that their people have to be                                                              
trained.                                                                                                                        
                                                                                                                                
SENATOR TORGERSON  noted a letter  from the Board to  Ms. Davidson                                                              
in which they approve  the 3,000 hours and moved  to pass CSSB 270                                                              
(L&C)  from  committee  with individual  recommendations  and  the                                                              
accompanying fiscal  note. There were no objections and  it was so                                                              
ordered.                                                                                                                        

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