Legislature(2015 - 2016)BELTZ 105 (TSBldg)

03/29/2016 01:30 PM Senate LABOR & COMMERCE

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Audio Topic
01:32:43 PM Start
01:33:12 PM Confirmation Hearings
02:11:18 PM SB206
02:42:01 PM SB55
03:36:06 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Consideration of Governor's Appointees: TELECONFERENCED
Alaska Gasline Development Corporation Board of
Directors
*+ SB 206 REINSURANCE PROGRAM; HEALTH INS. WAIVERS TELECONFERENCED
Heard & Held
+= SB 55 OPTOMETRY & OPTOMETRISTS TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
-- Public Testimony --
                 SB 55-OPTOMETRY & OPTOMETRISTS                                                                             
                                                                                                                                
2:42:01 PM                                                                                                                    
CHAIR COSTELLO  announced the consideration  of SB 55.  She noted                                                               
this is the  second hearing and the intent is  to continue public                                                               
testimony.                                                                                                                      
                                                                                                                                
2:42:55 PM                                                                                                                    
DR.  MIKE  BENNETT,  OD,  Alaska  Optometric  Association  (AOA),                                                               
testified  in support  of SB  55. He  provided his  education and                                                               
work history. He said there have  been a lot of fairy tales about                                                               
what the  bill would do and  they are not accurate.  He countered                                                               
the  notion   that  the  AOA  board   would  authorize  untrained                                                               
procedures  should  the bill  pass.  He  pointed out  that  self-                                                               
regulating  boards  have a  long  history  of success  and  their                                                               
primary  charge is  to protect  the  public. There  is no  hidden                                                               
agenda.                                                                                                                         
                                                                                                                                
2:45:46 PM                                                                                                                    
BOB PALMER,  State Affairs Policy  Director, American  Academy of                                                               
Ophthalmology, testified  in opposition to  SB 55. He  focused on                                                               
policy  issues, especially  the  language in  the bill  regarding                                                               
surgery,  which  leaves  open what  is  acceptable.  He  believes                                                               
optometrists would be able to  perform several hundred additional                                                               
surgical   procedures,  which   is  unacceptable.   He  suggested                                                               
defining what constitutes  surgery and then back  out what should                                                               
not be included.                                                                                                                
                                                                                                                                
He  discussed how  other  states have  addressed  this issue.  He                                                               
concluded that defining surgery protects the patient.                                                                           
                                                                                                                                
2:50:27 PM                                                                                                                    
SENATOR GIESSEL asked where he is from.                                                                                         
                                                                                                                                
MR. PALMER said Washington D.C.                                                                                                 
                                                                                                                                
SENATOR GIESSEL asked if his  organization paid for movie, radio,                                                               
and TV ads, robocalls, and mailings.                                                                                            
                                                                                                                                
MR.  PALMER  said  no.  They  gave  the  Alaska  Society  of  Eye                                                               
Physicians and Surgeons a grant of about $50,000.                                                                               
                                                                                                                                
CHAIR COSTELLO asked  him to provide the  specific information to                                                               
the committee.                                                                                                                  
                                                                                                                                
2:51:55 PM                                                                                                                    
PAUL MARKS,  representing himself, testified in  opposition to SB
55. He  shared a personal  experience with optometrists  and said                                                               
he doesn't  support an  optometrist doing  surgery when  he isn't                                                               
qualified to do so.                                                                                                             
                                                                                                                                
SENATOR GIESSEL asked if an optometrist did surgery on his eye.                                                                 
                                                                                                                                
MR. MARKS answered no; he went to Anchorage.                                                                                    
                                                                                                                                
SENATOR  GIESSEL restated  that the  optometrist did  not perform                                                               
surgery.                                                                                                                        
                                                                                                                                
2:55:53 PM                                                                                                                    
DR. GRIFFITH  STEINER, MD, testified  in opposition to SB  55. He                                                               
provided  his  professional  education  and practice  as  an  eye                                                               
surgeon.  He  described this  bill  as  specifically designed  to                                                               
expand  the scope  of practice  for optometrists.  It allows  for                                                               
injections around the  eye and the right to do  laser surgery. He                                                               
maintained that  they will not  have enough training to  do those                                                               
procedures.                                                                                                                     
                                                                                                                                
SENATOR GIESSEL  asked if the State  Medical Board has a  list of                                                               
surgeries that he can perform.                                                                                                  
                                                                                                                                
DR. STEINER said no, because physicians have medical training.                                                                  
                                                                                                                                
SENATOR GIESSEL emphasized that the  bill does not contain a list                                                               
that defines what the Board  of Medicine can authorize. She asked                                                               
if  his  authorization  is  based  on  his  education,  which  is                                                               
determined by the board.                                                                                                        
                                                                                                                                
DR. STEINER said yes; however,  a medical board is different than                                                               
an optometry  board, because the medical  board represents people                                                               
that are  trained in medicine  and surgery, with many  more years                                                               
of training.                                                                                                                    
                                                                                                                                
SENATOR  GIESSEL   said  optometrists  are  not   asking  for  an                                                               
expansion of practice.                                                                                                          
                                                                                                                                
DR. STEINER disagreed.                                                                                                          
                                                                                                                                
2:59:55 PM                                                                                                                    
MICHEAL GUZMAN, representing himself,  testified in opposition to                                                               
SB 55. He offered his understanding  that the bill would allow an                                                               
optometrist to  perform eye surgery  and prescribe  narcotics and                                                               
he does not support that.                                                                                                       
                                                                                                                                
SENATOR GIESSEL asked who told him those things.                                                                                
                                                                                                                                
MR. GUZMAN said he  read it online and heard it  on the radio. He                                                               
said he also researched the bill.                                                                                               
                                                                                                                                
SENATOR GIESSEL asked if he  is aware that optometrists have been                                                               
allowed to prescribe narcotics for nine years.                                                                                  
                                                                                                                                
MR. GUZMAN  said he wasn't  aware of that.  He asked if  they can                                                               
prescribe to the same degree.                                                                                                   
                                                                                                                                
SENATOR GIESSEL  said it may  help if he  was aware that  many of                                                               
the courses optometrists take are  taught by the same instructors                                                               
as   ophthalmologists  and   they  both   obtain  the   same  DEA                                                               
authorization.                                                                                                                  
                                                                                                                                
3:02:41 PM                                                                                                                    
MATTHEW GLYNN,  representing himself, testified in  opposition to                                                               
SB 55.  He shared  his story  of wanting  laser surgery  and only                                                               
finding   he   wasn't   a   candidate    when   he   visited   an                                                               
ophthalmologist.                                                                                                                
                                                                                                                                
SENATOR  GIESSEL  asked  if any  of  the  optometrists  performed                                                               
surgery.                                                                                                                        
                                                                                                                                
MR. GLYNN answered no.                                                                                                          
                                                                                                                                
3:04:36 PM                                                                                                                    
TIM SMITH,  representing himself,  testified in opposition  to SB
55. He  spoke as a medical  professional who was not  in favor of                                                               
cross training in different modalities for licensure.                                                                           
                                                                                                                                
3:05:38 PM                                                                                                                    
EDDY IVIZARY,  representing himself,  testified in  opposition to                                                               
SB  55. He  said  that he  feels that  only  a qualified  surgeon                                                               
should be able to operate on eyes. He shared his personal story.                                                                
                                                                                                                                
SENATOR GIESSEL  asked who  told him  that optometrists  would be                                                               
doing eye surgery.                                                                                                              
                                                                                                                                
MR. IVIZARY  restated his  personal story  and the  importance of                                                               
being able to see.                                                                                                              
                                                                                                                                
SENATOR GIESSEL asked if an  optometrist had ever done surgery or                                                               
put a needle in his eye.                                                                                                        
                                                                                                                                
MR. IVIZARY said yes and he told him to stop.                                                                                   
                                                                                                                                
3:08:28 PM                                                                                                                    
DR.  MICHAEL   BRENNAN,  Ophthalmologist,   Alaska  Ophthalmology                                                               
Society,  testified  in  opposition  to  SB  55.  He  shared  his                                                               
professional background.  He maintained  that the  bill endangers                                                               
the health of  the citizens of Alaska. The bill  has two inherent                                                               
flaws;  the brevity  in the  education and  training required  to                                                               
manage complex  medical and surgical conditions,  and second, the                                                               
vague language  regarding penetrative surgery. He  also addressed                                                               
the over-prescribing of potent pharmaceuticals.                                                                                 
                                                                                                                                
SENATOR GIESSEL asked how much  money the society has invested in                                                               
ads opposing the bill.                                                                                                          
                                                                                                                                
DR. BRENNAN  said the organization  invests in a wide  variety of                                                               
advocacy activities in  order to provide patient  safety. He said                                                               
he has  not made a direct  contribution to those ads.  He did not                                                               
know how much the organization spent.                                                                                           
                                                                                                                                
SENATOR  GIESSEL asked  if he  is aware  that optometry  has been                                                               
prescribing controlled substances for nine years.                                                                               
                                                                                                                                
DR. BRENNAN said they don't for  for schedule IA and schedule IIA                                                               
drugs. He said the bill expands the pharmaceutical array.                                                                       
                                                                                                                                
SENATOR GIESSEL said the bill doesn't say that.                                                                                 
                                                                                                                                
3:15:28 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
3:16:08 PM                                                                                                                    
CHAIR COSTELLO reconvened the meeting.                                                                                          
                                                                                                                                
3:16:49 PM                                                                                                                    
LUCRETIA   ANN   DEMIS,   representing  herself,   testified   in                                                               
opposition to SB  55. She doesn't think  that optometrists should                                                               
be  authorized  to   do  the  same  surgical   procedures  as  an                                                               
ophthalmologist.  She said  they don't  have  enough training  or                                                               
background.                                                                                                                     
                                                                                                                                
SENATOR  GIESSEL pointed  out that  an optometrist  refers people                                                               
when they need surgery.                                                                                                         
                                                                                                                                
3:20:29 PM                                                                                                                    
DR. ALFRED  DERAMUS, Ophthalmologist, testified in  opposition to                                                               
SB  55.  He  shared  his professional  background.  He  said  the                                                               
legislation is  poorly written and  will not gather  consensus on                                                               
either side  of the  issue because  of its  content. Some  of the                                                               
language  such   as  "invasive  surgery"  and   "injections"  are                                                               
inflammatory  and don't  adequately address  what is  and is  not                                                               
surgical.                                                                                                                       
                                                                                                                                
3:23:25 PM                                                                                                                    
PAUL  BARNEY,   Chair,  Alaska  Board  of   Optometry  Examiners,                                                               
testified in  support of SB  55. He  said his primary  concern is                                                               
the safety  of the public. In  his four years on  the board there                                                               
have  not  been   complaints  that  rose  to  the   level  of  an                                                               
investigation.  In  general,  optometrists are  conservative  and                                                               
cautious providers.  The bill will  not allow the board  to write                                                               
regulations outside  of optometrists' training. He  mentioned the                                                               
board has  oversight by the  attorney general, the same  as other                                                               
healthcare  providers.  They have  no  intention  of lifting  the                                                               
four-day limit  on prescribing narcotics. SB  55 would modernized                                                               
the definition of optometry and  reflect what is currently taught                                                               
in schools of optometry.                                                                                                        
                                                                                                                                
3:27:21 PM                                                                                                                    
DR. DAVID ZUMBRO, Ophthalmologist,  testified in opposition to SB
55. He said his  primary issue with SB 55 is  that it attempts to                                                               
define   invasive  surgery.   As  written,   the  definition   is                                                               
incomplete and wide open to  interpretation. He suggested that be                                                               
changed.                                                                                                                        
                                                                                                                                
SENATOR GIESSEL asked  if he has had optometrists  do surgery and                                                               
had the patient referred to him afterwards.                                                                                     
                                                                                                                                
DR. ZUMBRO said no.                                                                                                             
                                                                                                                                
3:29:12 PM                                                                                                                    
DR. ROBERT ARNOLD, representing  himself, testified in opposition                                                               
to SB  55. He said,  as a pediatric ophthalmologist,  he performs                                                               
two complex  procedures that are  not described in the  bill. His                                                               
concern is  that the definition  of surgery  is loose and  may be                                                               
open to interpretation. He noted  oversight of safety for surgery                                                               
in Alaska  occurs via licensure  and hospital  privilege surgical                                                               
review.                                                                                                                         
                                                                                                                                
SENATOR  GIESSEL asked  if he's  had  problems with  optometrists                                                               
performing rash interventions.                                                                                                  
                                                                                                                                
DR.  ARNOLD  said  he  has   not  experienced  surgical  care  by                                                               
optometrists, but he has experienced  excellent care by them. His                                                               
partners have  been optometrists. He  said his concern is,  as an                                                               
educator,   that   surgical   oversight  is   not   afforded   to                                                               
optometrists.                                                                                                                   
                                                                                                                                
3:32:09 PM                                                                                                                    
STEVE   DOBSON,   President,   Alaska   Optometric   Association,                                                               
testified  in  support  of  SB 55.  He  shared  his  professional                                                               
background. He  said Alaskans  have benefitted  tremendously from                                                               
the increase  in access  to quality  medical optometric  eye care                                                               
due  to past  legislation.  The  goal of  the  association is  to                                                               
ensure  the  best  practice  of  care and  to  attract  the  best                                                               
graduates  from the  colleges of  optometry. SB  55 is  not about                                                               
allowing eye  surgery, but rather  about board autonomy.  To date                                                               
the  board has  demonstrated  superb  confidence, integrity,  and                                                               
professionalism  protecting  the  interest   of  the  public  and                                                               
passage of the bill would allow continuation of that.                                                                           
                                                                                                                                
CHAIR  COSTELLO  closed  public  testimony  and  held  SB  55  in                                                               
committee.                                                                                                                      

Document Name Date/Time Subjects
Gasline Development - Cruz #1.pdf SL&C 3/29/2016 1:30:00 PM
Gasline Development- Hopkins #1.pdf SL&C 3/29/2016 1:30:00 PM
Gasline Development- Merrick #1.pdf SL&C 3/29/2016 1:30:00 PM
Alaska Gasline Development Corporation Factsheet.pdf SL&C 3/29/2016 1:30:00 PM
1 - Alaska Gasline Development Corporation Roster.pdf SL&C 3/29/2016 1:30:00 PM
SB 206.PDF SL&C 3/29/2016 1:30:00 PM
SB 206
SB 206 - Fiscal Note.pdf SL&C 3/29/2016 1:30:00 PM
SB 206
2016.03.28 Division of Insurance - Reinsurance White Paper.pdf SL&C 3/29/2016 1:30:00 PM
2016.03.28 - Premera Reinsurance White Paper.pdf SL&C 3/29/2016 1:30:00 PM
SB 55 - Association of Eye Surgeons - SB 55 Surgeries List.pdf SL&C 3/29/2016 1:30:00 PM
SB 55
SB 55 - Opposition Article - Alaska should leave eye surgery to the surgeons.pdf SL&C 3/29/2016 1:30:00 PM
SB 55
SB 55 - Opposition - ASPS Comments - Scope Optometric - AK SB55 - 03-21-16.pdf SL&C 3/29/2016 1:30:00 PM
SB 55
SB 55 - Opposition Letter - Dr. Korshin.pdf SL&C 3/29/2016 1:30:00 PM
SB 55
SB 55 - Support Background Document - AOA Malpractice Fact Sheet.pdf SL&C 3/29/2016 1:30:00 PM
SB 55
SB 55 - Support Letter - AOA.pdf SL&C 3/29/2016 1:30:00 PM
SB 55
SB 55 - Support Letter - Dr. Karpik.pdf SL&C 3/29/2016 1:30:00 PM
SB 55
SB 206 - RWJ Foundation - Innovation Waivers 1.pdf SL&C 3/29/2016 1:30:00 PM
SB 206
SB 206 - RWJ Foundation - Innovation Waivers 2.pdf SL&C 3/29/2016 1:30:00 PM
SB 206
SB 206 - RWJ Foundation - Innovation Waivers 3.pdf SL&C 3/29/2016 1:30:00 PM
SB 206
SB 206 - Hearing Request.pdf SL&C 3/29/2016 1:30:00 PM
SB 206
SB 206 - Sectional Analysis.pdf SL&C 3/29/2016 1:30:00 PM
SB 206
SB 206 - Support Letter - AAHU.pdf SL&C 3/29/2016 1:30:00 PM
SB 206
SB 206.PDF SL&C 3/29/2016 1:30:00 PM
SB 206