Legislature(2017 - 2018)BARNES 124

03/27/2017 03:15 PM LABOR & COMMERCE

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Audio Topic
03:19:25 PM Start
03:20:12 PM Confirmation Hearings
03:52:04 PM HB170
03:56:34 PM HB103
05:09:04 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Confirmation Hearings: TELECONFERENCED
AK State Board of Public Accountancy;
Alcoholic Beverage Control Board; State Board of
Registration for Architects, Engineers & Land
Surveyors; Board of Barbers & Hairdressers;
Board of Chiropractic Examiners; Board of Dental
Examiners; AK Labor Relations Agency; Marijuana
Control Board; Board of Marine Pilots; Board of
Marital & Family Therapy; Board of Massage
Therapists; Board of Certified Direct-Entry
Midwives; Board of Nursing; Occupational Safety
& Health Review Board; Board of Examiners in
Optometry; Board of Pharmacy; State Physical
Therapy & Occupational Therapy Board; Board of
Professional Counselors; Board of Psychologists
& Psychological Associate Examiners; Board of
Certified Real Estate Appraisers; Real Estate
Commission; Workers' Compensation Appeals
Commission; AK Workers' Compensation Board; AK
Gasline Development Corporation Board of
Directors; AK Oil & Gas Conservation Commission
+ HB 103 OPTOMETRY & OPTOMETRISTS TELECONFERENCED
Heard & Held
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 170 AK SECURITIES ACT; PENALTIES; CRT. RULES TELECONFERENCED
Moved HB 170 Out of Committee
-- Public Testimony --
                    ALASKA STATE LEGISLATURE                                                                                  
          HOUSE LABOR AND COMMERCE STANDING COMMITTEE                                                                         
                         March 27, 2017                                                                                         
                           3:19 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Sam Kito, Chair                                                                                                  
Representative Adam Wool, Vice Chair                                                                                            
Representative Andy Josephson                                                                                                   
Representative Louise Stutes                                                                                                    
Representative Chris Birch                                                                                                      
Representative Gary Knopp                                                                                                       
Representative Colleen Sullivan-Leonard                                                                                         
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Mike Chenault (alternate)                                                                                        
Representative Bryce Edgmon (alternate)                                                                                         
                                                                                                                                
OTHER MEMBERS PRESENT                                                                                                         
                                                                                                                                
Representative Zach Fansler                                                                                                     
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
CONFIRMATION HEARING(S):                                                                                                        
                                                                                                                                
Alaska State Board of Public Accountancy                                                                                      
                                                                                                                                
     Wayne Hogue  Kotzebue                                                                                                      
     Donovan Rulien II  Anchorage                                                                                               
     Marja Beltrami  Anchorage                                                                                                  
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Alcoholic Beverage Control Board                                                                                              
                                                                                                                                
     Robert Klein  Anchorage                                                                                                    
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
State Board of Registration for Architects, Engineers and Land                                                                
Surveyors                                                                                                                     
                                                                                                                                
     Jeffrey Koonce  Anchorage                                                                                                  
     Elizabeth Johnston  Fairbanks                                                                                              
     John Kerr  Anchorage                                                                                                       
     Richard Jones  Juneau                                                                                                      
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Barbers and Hairdressers                                                                                             
                                                                                                                                
     Michelle McMullin  Anchorage                                                                                               
     Jennifer Lombardo  Anchorage                                                                                               
     Terriann Shell   Big Lake                                                                                                  
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Chiropractic Examiners                                                                                               
                                                                                                                                
     Jonathan Vito  Anchorage                                                                                                   
     Brian Larson  Soldotna                                                                                                     
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Dental Examiners                                                                                                     
                                                                                                                                
     Michael Moriarty  Seward                                                                                                   
     Steven Scheller  Fairbanks                                                                                                 
     Gail Walden  Wasilla                                                                                                       
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Alaska Labor Relations Agency                                                                                                 
                                                                                                                                
     Elizabeth Pierce  Anchorage                                                                                                
     Lee Holen  Anchorage                                                                                                       
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Marijuana Control Board                                                                                                       
                                                                                                                                
     Nicholas Miller   Anchorage                                                                                                
     Peter Mlynarik  Soldotna                                                                                                   
     Mark Springer  Bethel                                                                                                      
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Marine Pilots                                                                                                        
                                                                                                                                
     Ronald Ward II   Anchorage                                                                                                 
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Marital and Family Therapy                                                                                           
                                                                                                                                
     Nicole Jenkins  Palmer                                                                                                     
     Karen Cunningham  Anchorage                                                                                                
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Massage Therapists                                                                                                   
                                                                                                                                
     Traci Gilmour  Juneau                                                                                                      
     Jill Motz  Wasilla                                                                                                         
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Certified Direct-Entry Midwives                                                                                      
                                                                                                                                
     Kathy Roberts  Anchorage                                                                                                   
     Dana Brown  Fairbanks                                                                                                      
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Nursing                                                                                                              
                                                                                                                                
     Joseph Lefleur  Ketchikan                                                                                                  
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Occupational Safety and Health Review Board                                                                                   
                                                                                                                                
     Thomas Trosvig  Kodiak                                                                                                     
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Alaska Oil and Gas Conservation Commission                                                                                    
                                                                                                                                
     Daniel Seamount  Anchorage                                                                                                 
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Examiners in Optometry                                                                                               
                                                                                                                                
     Erik Christianson  Ketchikan                                                                                               
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Pharmacy                                                                                                             
                                                                                                                                
     Taryl Giessel  Eagle River                                                                                                 
     Lana Bell  Anchorage                                                                                                       
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
State Physical Therapy and Occupational Therapy Board                                                                         
                                                                                                                                
     Jennifer Carlson  Fairbanks                                                                                                
     Rebecca Bingham  Anchorage                                                                                                 
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Professional Counselors                                                                                              
                                                                                                                                
     Eleanor Vinson  Juneau                                                                                                     
     Anne Brainerd Marko  Fairbanks                                                                                             
     Debra Hamilton  Soldotna                                                                                                   
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Psychologists and Psychological Associate Examiners                                                                  
                                                                                                                                
     Deborah Gideon  Anchorage                                                                                                  
     Suzanne Dutson  Juneau                                                                                                     
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Board of Certified Real Estate Appraisers                                                                                     
                                                                                                                                
     Renee Piszczek  Fairbanks                                                                                                  
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Real Estate Commission                                                                                                        
                                                                                                                                
     Eric Bushnell  Wasilla                                                                                                     
     Guy Mickel   Ward Cove                                                                                                     
     David Pruhs   Fairbanks                                                                                                    
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Workers' Compensation Appeals Commission                                                                                      
                                                                                                                                
     Deirdre Ford  Anchorage                                                                                                    
     Stephen Hagedorn  Anchorage                                                                                                
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Alaska Workers' Compensation Board                                                                                            
                                                                                                                                
     Brett Stubbs  Anchorage                                                                                                    
     Linda Murphy  Soldotna                                                                                                     
     Donna Phillips  Girdwood                                                                                                   
     Aaron Plikat  Anchorage                                                                                                    
     Lake Williams  Fairbanks                                                                                                   
     Saleutogi Letuligasenoa  Fairbanks                                                                                         
     Rick Traini  Anchorage                                                                                                     
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
Alaska Gasline Development Corporation Board of Directors                                                                     
                                                                                                                                
     David Wight  Anchorage                                                                                                     
     Hugh Short  Girdwood                                                                                                       
     Warren Christian  North Pole                                                                                               
                                                                                                                                
     - CONFIRMATION(S) ADVANCED                                                                                                 
                                                                                                                                
HOUSE BILL NO. 170                                                                                                              
"An Act relating to  securities, registration, exempt securities,                                                               
exempt transactions,  broker-dealers, agents,  investment advice,                                                               
investment advisers, investment  adviser representatives, federal                                                               
covered   securities,   federal  covered   investment   advisers,                                                               
viatical   settlement   interests,  small   intrastate   security                                                               
offerings,   Canadian   broker-dealers,  and   Canadian   agents;                                                               
relating  to  administrative,  civil,  and  criminal  enforcement                                                               
provisions,  including   restitution  and  civil   penalties  for                                                               
violations; relating  to an investor training  fund; establishing                                                               
increased  civil   penalties  for   harming  older   persons  and                                                               
vulnerable adults;  relating to corporations organized  under the                                                               
Alaska Native  Claims Settlement  Act; amending  Rules 4,  5, 54,                                                               
65,  and 90,  Alaska  Rules  of Civil  Procedure,  and Rule  602,                                                               
Alaska  Rules  of  Appellate  Procedure;  and  providing  for  an                                                               
effective date."                                                                                                                
                                                                                                                                
     - MOVED HB 170 OUT OF COMMITTEE                                                                                            
                                                                                                                                
HOUSE BILL NO. 103                                                                                                              
"An Act relating to the practice of optometry."                                                                                 
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 170                                                                                                                  
SHORT TITLE: AK SECURITIES ACT; PENALTIES; CRT. RULES                                                                           
SPONSOR(s): LABOR & COMMERCE                                                                                                    
                                                                                                                                
03/10/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/10/17       (H)       L&C, JUD                                                                                               
03/24/17       (H)       L&C AT 3:15 PM BARNES 124                                                                              
03/24/17       (H)       Heard & Held                                                                                           
03/24/17       (H)       MINUTE(L&C)                                                                                            
03/27/17       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
BILL: HB 103                                                                                                                  
SHORT TITLE: OPTOMETRY & OPTOMETRISTS                                                                                           
SPONSOR(s): SPOHNHOLZ                                                                                                           
                                                                                                                                
02/03/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/03/17       (H)       HSS, L&C                                                                                               
03/14/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/14/17       (H)       Heard & Held                                                                                           
03/14/17       (H)       MINUTE(HSS)                                                                                            
03/16/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/16/17       (H)       Scheduled but Not Heard                                                                                
03/18/17       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/18/17       (H)       Moved CSHB 103(HSS) Out of Committee                                                                   
03/18/17       (H)       MINUTE(HSS)                                                                                            
03/22/17       (H)       HSS RPT CS(HSS) NT 5DP 1NR                                                                             
03/22/17       (H)       DP: JOHNSTON, TARR, SULLIVAN-LEONARD,                                                                  
                        KITO, SPOHNHOLZ                                                                                         
03/22/17       (H)       NR: EASTMAN                                                                                            
03/27/17       (H)       L&C AT 3:15 PM BARNES 124                                                                              
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
JONATHAN VITO, Appointee                                                                                                        
Board of Chiropractic Examiners                                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified as appointee to the Board of                                                                   
Chiropractic Examiners.                                                                                                         
                                                                                                                                
ROBERT KLEIN, Appointee                                                                                                         
Alcoholic Beverage Control Board ("ABC Board")                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified as appointee to the Alcoholic                                                                  
Beverage Control Board.                                                                                                         
                                                                                                                                
LEE HOLEN, Appointee                                                                                                            
Alaska Labor Relations Agency                                                                                                   
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified as appointee to the Alaska Labor                                                               
Relations Agency.                                                                                                               
                                                                                                                                
SUZANNE DUTSON, Appointee                                                                                                       
Board of Psychologists and Psychological Associate Examiners                                                                    
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified as appointee to the Board of                                                                   
Psychologists and Psychological Associate Examiners.                                                                            
                                                                                                                                
MICHAEL MORIARTY, DDS, Appointee                                                                                                
Board of Dental Examiners                                                                                                       
Seward, Alaska                                                                                                                  
POSITION STATEMENT:  Testified as appointee to the Board of                                                                   
Dental Examiners.                                                                                                               
                                                                                                                                
REPRESENTATIVE IVY SPOHNHOLZ                                                                                                    
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  As prime sponsor, presented HB 103.                                                                      
                                                                                                                                
BERNICE NISBETT, Staff                                                                                                          
Representative Ivy Spohnholz                                                                                                    
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented a sectional analysis for CSHB                                                                  
103(HSS), on behalf of Representative Spohnholz, prime sponsor.                                                                 
                                                                                                                                
HARRIET MILKS, Assistant Attorney General                                                                                       
Commercial and Fair Business Section                                                                                            
Civil Division, Juneau                                                                                                          
Department of Law (DOL)                                                                                                         
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions during the hearing on HB                                                              
103.                                                                                                                            
                                                                                                                                
PAUL BARNEY, MD, Chair                                                                                                          
Board of Examiners on Optometry                                                                                                 
Division of Corporations, Business, and Professional Licensing                                                                  
Department of Commerce, Community & Economic Development (DCCED)                                                                
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 103.                                                                          
                                                                                                                                
JILL GEERING MATHESON, OD                                                                                                       
Alaskan Vision Center Optometry                                                                                                 
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 103.                                                                          
                                                                                                                                
SCOTT LIMSTROM, MD, President                                                                                                   
Alaska Society of Eye Physicians and Surgeons (ASEPS)                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 103.                                                                       
                                                                                                                                
EVAN WOLF, MD, Wolf Eye Center                                                                                                  
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:  Testified in opposition to HB 103.                                                                       
                                                                                                                                
ERIK CHRISTIANSON, OD                                                                                                           
Ketchikan, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 103.                                                                          
                                                                                                                                
MATTHEW GUESS, MD                                                                                                               
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 103.                                                                       
                                                                                                                                
KELLY LORENZ, MD                                                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 103.                                                                       
                                                                                                                                
STEVE DOBSON, OD                                                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 103.                                                                          
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:19:25 PM                                                                                                                    
                                                                                                                                
CHAIR  SAM KITO  called  the House  Labor  and Commerce  Standing                                                             
Committee  meeting  to  order  at   3:19  p.m.    Representatives                                                               
Josephson,  Wool,  Birch,  Knopp, Stutes,  Sullivan-Leonard,  and                                                               
Kito were present at the call to order.                                                                                         
                                                                                                                                
^Confirmation Hearings                                                                                                          
                    CONFIRMATION HEARING(S)                                                                                 
            Alaska State Board of Public Accountancy                                                                        
                Alcoholic Beverage Control Board                                                                            
 State Board of Registration for Architects, Engineers and Land                                                             
                           Surveyors                                                                                        
               Board of Barbers and Hairdressers                                                                            
                Board of Chiropractic Examiners                                                                             
                   Board of Dental Examiners                                                                                
                 Alaska Labor Relations Agency                                                                              
                    Marijuana Control Board                                                                                 
                     Board of Marine Pilots                                                                                 
              Board of Marital and Family Therapy                                                                           
                  Board of Massage Therapists                                                                               
            Board of Certified Direct-Entry Midwives                                                                        
                        Board of Nursing                                                                                    
          Occupational Safety and Health Review Board                                                                       
                Board of Examiners in Optometry                                                                             
                       Board of Pharmacy                                                                                    
     State Physical Therapy and Occupational Therapy Board                                                                  
                Board of Professional Counselors                                                                            
  Board of Psychologists and Psychological Associate Examiners                                                              
           Board of Certified Real Estate Appraisers                                                                        
                     Real Estate Commission                                                                                 
            Workers' Compensation Appeals Commission                                                                        
               Alaska Workers' Compensation Board                                                                           
   Alaska Gasline Development Corporation Board of Directors                                                                
           Alaska Oil and Gas Conservation Commission                                                                       
                                                                                                                              
3:20:12 PM                                                                                                                    
                                                                                                                                
CHAIR KITO  announced that the  first order of business  would be                                                               
confirmation hearings  of the governor's appointments  to various                                                               
state boards and commissions.                                                                                                   
                                                                                                                                
CHAIR KITO  stated that  the committee received  61 names  of the                                                               
governor's appointments  and members  were asked to  submit names                                                               
of  any  appointees  they  wished   to  speak  with  directly  or                                                               
question.   He stated  that the committee  requested to  speak to                                                               
nine individuals.                                                                                                               
                                                                                                                                
3:21:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON  stated that  in his review  of Jonathan                                                               
Vito's curriculum vitae  (CV), Mr. Vito indicated he  or a family                                                               
member  might  have a  conflict  of  interest  but did  not  give                                                               
details.                                                                                                                        
                                                                                                                                
3:23:09 PM                                                                                                                    
                                                                                                                                
JONATHAN  VITO,  Appointee,   Board  of  Chiropractic  Examiners,                                                               
testified as  appointee to the  Board of  Chiropractic Examiners.                                                               
He  offered  clarification  on  his intent  in  filling  out  the                                                               
application.    He stated  that  the  conflicts implied  were  in                                                               
regard to peer  action, such as reprimanding or licensing.   As a                                                               
part owner of Better Health  Chiropractic & Physical Rehab, LLC.,                                                               
determining licensure  of someone who might  potentially work for                                                               
him could be a conflict of interest.                                                                                            
                                                                                                                                
REPRESENTATIVE JOSEPHSON  asked if Mr. Vito  would be comfortable                                                               
declaring such a conflict in a meeting of the board.                                                                            
                                                                                                                                
MR. VITO answered yes.                                                                                                          
                                                                                                                                
3:23:59 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD asked  for Mr. Vito's impressions                                                               
of how the  board works and what  he would bring to  the table to                                                               
help the board.                                                                                                                 
                                                                                                                                
MR. VITO  offered his  belief that the  board helps  to structure                                                               
Alaska statutes  regarding what the  chiropractors can do  in the                                                               
state.  He stated that he hopes  to bring new, young blood to the                                                               
board,  new   ways  of  thinking,   and  more   integration  into                                                               
chiropractic  clinics.   He stated  his  desire to  speed up  the                                                               
licensing process with  online tests for new  licensees and "when                                                               
we do  have the board meetings,  do their meeting with  the board                                                               
then and not have to wait every  three months to be able to get a                                                               
license."                                                                                                                       
                                                                                                                                
3:26:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON asked the  next appointee, Robert Klein,                                                               
whether  he would  produce disclosures  of  financial data  about                                                               
potential conflicts of  interest.  He stated that  when Mr. Klein                                                               
was asked  if there  could be any  potential family  conflict, he                                                               
said  no.    He  asked  if Mr.  Klein  is  declining  to  provide                                                               
financial data as required by law.                                                                                              
                                                                                                                                
3:26:40 PM                                                                                                                    
                                                                                                                                
ROBERT KLEIN,  Appointee, Alcoholic Beverage Control  Board ("ABC                                                               
Board"), testified as appointee to  the ABC Board.  Responding to                                                               
Representative Josephson's  question, he answered no.   He stated                                                               
that he recently filled out  his Alaska Public Offices Commission                                                               
(APOC)   disclosure,   which    gave   the   required   financial                                                               
information.  He  disclosed that if confirmed,  he would continue                                                               
to be an industry  member of the board.  He  informed that he has                                                               
served  on  the  board  for  a number  of  years  and  has  never                                                               
hesitated to declare any conflicts.                                                                                             
                                                                                                                                
REPRESENTATIVE JOSEPHSON asked for  confirmation that Mr. Klein's                                                               
financial data has been provided.                                                                                               
                                                                                                                                
MR. KLEIN  said that  he has  complied with  APOC [requirements],                                                               
which include financial reporting.                                                                                              
                                                                                                                                
3:27:29 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE STUTES  asked if  Mr. Klein is  currently involved                                                               
in the rewrite of Title IV.                                                                                                     
                                                                                                                                
MR. KLEIN stated  that he has been  on the board for  a number of                                                               
years and the [Title IV rewrite]  process has been going on since                                                               
May of 2012.  Last year,  the board brought forth Senate Bill 165                                                               
with a  portion of the  rewrite.  He  offered his hope  that this                                                               
year's SB 76 is  the end of a long road to rewrite  Title IV.  He                                                               
stated that he has been very involved in the rewrite process.                                                                   
                                                                                                                                
3:28:26 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE FANSLER  asked Mr. Klein  to explain his  views on                                                               
the  balance  of  power  between  the  ABC  Board  and  municipal                                                               
governments.                                                                                                                    
                                                                                                                                
MR. KLEIN responded that the  current structure of Title IV gives                                                               
municipalities the  chance to comment  on any license  that comes                                                               
before them  - either  new or  renewal licenses.   It  also gives                                                               
municipalities the right  to object to a license.   The ABC Board                                                               
can't override  that protest unless  the board finds  the protest                                                               
to be arbitrary, unreasonable, or  capricious.  He expressed that                                                               
municipalities have a tremendous say in what happens.                                                                           
                                                                                                                                
REPRESENTATIVE FANSLER  asked for  Mr. Klein's  interpretation of                                                               
arbitrary, capricious, and unreasonable.                                                                                        
                                                                                                                                
MR.  KLEIN stated  that it  usually means  that there  has either                                                               
been a  misinterpretation of  Title IV  or some  special interest                                                               
has overly  exerted influence on  a municipality's  decision that                                                               
is not fair  or logical.  He  stated that for the  most part, any                                                               
objection  from   a  municipality  is  carried   through  and  is                                                               
supported by the board.                                                                                                         
                                                                                                                                
3:30:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FANSLER   asked  Mr.   Klein  to  speak   to  his                                                               
experiences  in rural  Alaska and  any developments  he has  been                                                               
following  in communities  that are  transitioning to  new phases                                                               
with alcohol.                                                                                                                   
                                                                                                                                
MR. KLEIN  responded that  he has  served on  the board  for many                                                               
years and the board has  been very involved in rural communities.                                                               
The board is  required to meet in every judicial  district once a                                                               
year,    and   the    board    encourages   local    communities'                                                               
representatives to  come forward.   He stated that the  board has                                                               
used  these meetings  as an  educational  tool.   He spoke  about                                                               
meeting in Nome where the board  met with members of the assembly                                                               
to  educate them  on the  rights and  responsibilities they  have                                                               
regarding licenses.                                                                                                             
                                                                                                                                
REPRESENTATIVE  FANSLER asked  if the  possible Title  IV changes                                                               
could affect rural communities deciding  if they want to be damp,                                                               
dry, or wet.                                                                                                                    
                                                                                                                                
MR.  KLEIN  stated  that  the  Title  IV  changes  mostly  regard                                                               
enforcement, troopers,  and alcohol  consumption in  rural areas.                                                               
The board  discovered that  the marijuana  industry's regulations                                                               
made necessary tweaks  to the way localities select  and put into                                                               
effect local options.  He offered  that the board's next phase of                                                               
Title IV changes would address  some of those issues.  Currently,                                                               
Title IV is mainly concerned with enforcement.                                                                                  
                                                                                                                                
3:32:37 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FANSLER   asked  how  Title  IV   may  anticipate                                                               
problems of enforcement  in dry villages when  a nearby community                                                               
goes wet.   He asked what tools could help  communities that wish                                                               
to be dry.                                                                                                                      
                                                                                                                                
MR. KLEIN  stated that  it is  a real conundrum.   The  board has                                                               
tried to "sure  up" enforcement and improve data  collection.  He                                                               
remarked, "The  real issues are  with the villages, how  they ...                                                               
teach and  train people  to stay  out of  ... the  adjacent areas                                                               
where  alcohol is  readily available."    He stated  that when  a                                                               
license like that comes up before  the ABC Board, the board looks                                                               
at  what steps  can be  taken and  makes sure  that the  licensee                                                               
understands  the  coinciding  responsibility to  the  surrounding                                                               
communities.                                                                                                                    
                                                                                                                                
3:34:27 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL noted that last  year a bill about the makeup                                                               
of the board was  passed.  He asked if Mr.  Klein thinks that the                                                               
current  makeup  of  the  board is  functioning  well,  and  that                                                               
industry representation is adequate.                                                                                            
                                                                                                                                
MR.  KLEIN responded,  "I  do."   He stated  that  the model  has                                                               
existed since  the 1980s  and has  been working  well.   He noted                                                               
that last  year's House  Bill 165 created  a permanent  chair for                                                               
public  safety.   He expressed  that throughout  the years,  most                                                               
governors have  appointed someone  with an affiliation  to public                                                               
safety, so  it wasn't a radical  change.  He offered  his opinion                                                               
that  the size  of the  board  - five  members -  and having  two                                                               
industry members works extremely well.                                                                                          
                                                                                                                                
3:35:46 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL  analyzed that with a  five-member board, two                                                               
industry  representatives  are "about  all  you  could do."    He                                                               
commented that  the industry  has changed  lately with  a growing                                                               
brewery industry.   He stated  that distribution, beer  and wine,                                                               
beverage   dispensary,  and   other  license   holders  are   not                                                               
represented  by  the  board.    He  noted  that  Mr.  Klein,  who                                                               
represents the  distillery portion  of the  industry, has  held a                                                               
seat at the  board for many years.   He asked if  there should be                                                               
more representation from the other areas of the industry.                                                                       
                                                                                                                                
MR. KLEIN  stated that he also  serves on the board  of directors                                                               
for   Alaska    Cabaret,   Hotel,   Restaurant    and   Retailers                                                               
Association's  (CHARR).    He  noted that  the  CHARR  Board  has                                                               
several  members who  are  manufacturers  and has  representation                                                               
from all aspects of retail.   He stated that there are good lines                                                               
of communication.   He explained that in his past,  he spent time                                                               
working in retail  and consulting wholesalers, and he  now runs a                                                               
distillery;  therefore,   he  has   experience  with   the  whole                                                               
industry.     He  expressed  that   the  industry   has  adequate                                                               
representation on the ABC Board.                                                                                                
                                                                                                                                
3:37:26 PM                                                                                                                    
                                                                                                                                
CHAIR  KITO commented  that the  current Title  IV rewrite  deals                                                               
with  enforcement.   Alaska  has a  geographic  issue that  makes                                                               
enforcing  some   components  of   law  in   smaller  communities                                                               
difficult.  He  offered his opinion that it is  important to have                                                               
tools in place  to ensure that communities that wish  to stay dry                                                               
have the  ability to do so  without a flood of  product coming in                                                               
from an adjacent wet community.  He remarked,                                                                                   
                                                                                                                                
     As you're  looking at enforcement or  as you're looking                                                                    
     at possible ... statutory  changes, with your expertise                                                                    
     in the industry, with the  other members of the board's                                                                    
     expertise in their areas, I  think it will be important                                                                    
     to try and  figure out how we can help  support some of                                                                    
     these  communities  that  really  do want  to  try  and                                                                    
     protect  their citizens.   ...  And instead  of drawing                                                                    
     the line around the community  that's going wet, can we                                                                    
     try and  figure out a  way that  we can enable  some of                                                                    
     these smaller  communities to have tools  that can help                                                                    
     protect   them   from   alcohol   coming   into   their                                                                    
     communities?                                                                                                               
                                                                                                                                
CHAIR KITO  asked Mr. Klein  to consider his comments  during his                                                               
service with the ABC Board.                                                                                                     
                                                                                                                                
MR. KLEIN responded, "It's advice well taken."                                                                                  
                                                                                                                                
CHAIR KITO thanked Mr. Klein for  his willingness to serve on the                                                               
board.   He noted that  the committee  would next speak  with Lee                                                               
Holen.                                                                                                                          
                                                                                                                                
3:39:31 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON  noted  that  Ms.  Holen's  application                                                               
stated  that she  would fully  disclose personal  financial data,                                                               
and she  declared that there could  be a conflict of  interest if                                                               
she  were appointed  to the  Alaska Labor  Relations Agency.   He                                                               
asked her to explain.                                                                                                           
                                                                                                                                
3:40:16 PM                                                                                                                    
                                                                                                                                
LEE HOLEN,  Appointee, Alaska  Labor Relations  Agency, testified                                                               
as appointee  to the Alaska  Labor Relations Agency.   She stated                                                               
that she was concerned about  a potential conflict of interest if                                                               
one of her clients were to  come before the board.  She expressed                                                               
that  she does  not foresee  any financial  conflict because  she                                                               
wouldn't  hear  a matter  involving  someone  from whom  she  had                                                               
received financial benefits.                                                                                                    
                                                                                                                                
3:40:49 PM                                                                                                                    
                                                                                                                                
CHAIR KITO thanked  Ms. Holen for speaking to the  committee.  He                                                               
noted that the committee would next speak with Suzanne Dutson.                                                                  
                                                                                                                                
3:41:10 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON stated  that Ms.  Dutson's CV  reflects                                                               
that the governor wisely chose  someone with a strong background.                                                               
He  asked if  Ms.  Dutson  is willing  to  disclose her  personal                                                               
financial data as required.                                                                                                     
                                                                                                                                
3:42:05 PM                                                                                                                    
                                                                                                                                
SUZANNE   DUTSON,   Appointee,   Board   of   Psychologists   and                                                               
Psychological Associate Examiners, testified  as appointee to the                                                               
Board  of Psychologists  and  Psychological Associate  Examiners.                                                               
She   responded   "absolutely"  to   Representative   Josephson's                                                               
question.                                                                                                                       
                                                                                                                                
REPRESENTATIVE JOSEPHSON  commented that  he wanted to  make sure                                                               
appointees know it is a current responsibility.                                                                                 
                                                                                                                                
3:42:40 PM                                                                                                                    
                                                                                                                                
CHAIR KITO thanked Ms. Dutson for  speaking to the committee.  He                                                               
noted  that  the committee  would  next  speak with  Dr.  Michael                                                               
Moriarty.                                                                                                                       
                                                                                                                                
3:43:00 PM                                                                                                                    
                                                                                                                                
MICHAEL  MORIARTY, DDS,  Appointee,  Board  of Dental  Examiners,                                                               
testified  as appointee  to the  Board of  Dental Examiners.   He                                                               
stated that he is a dentist in Seward, Alaska.                                                                                  
                                                                                                                                
[The committee asked Mr. Moriarty no questions.]                                                                                
                                                                                                                                
CHAIR KITO thanked Mr. Moriarty.                                                                                                
                                                                                                                                
3:44:05 PM                                                                                                                    
                                                                                                                                
CHAIR  KITO  reminded  the  members   that  signing  the  reports                                                               
regarding  appointments  to  boards  and commissions  in  no  way                                                               
reflects  individual  members'  approval or  disapproval  of  the                                                               
appointees, and that the nominations  are merely forwarded to the                                                               
full legislature for confirmation or rejection.                                                                                 
                                                                                                                                
3:44:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SULLIVAN-LEONARD  opined   that  the  information                                                               
attained  from the  appointees through  committee discussion  and                                                               
questions should be added to their CVs.                                                                                         
                                                                                                                                
CHAIR  KITO stated  his  belief that  applications  would not  be                                                               
modified; however, the questions  and responses would be included                                                               
in the written minutes and audio recording.                                                                                     
                                                                                                                                
3:45:11 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WOOL  moved  to  advance the  list  of  the  [57]                                                               
appointees  to various  boards and  commissions  reviewed by  the                                                               
House Labor and Commerce Standing  Committee to the joint session                                                               
of the House and Senate for consideration.                                                                                      
                                                                                                                                
3:45:24 PM                                                                                                                    
                                                                                                                                
CHAIR KITO  objected for the  purpose of acknowledging  the names                                                               
of the appointees whose confirmations  had been reviewed [details                                                               
provided in the committee calendar].                                                                                            
                                                                                                                                
3:49:07 PM                                                                                                                    
                                                                                                                                
CHAIR  KITO  removed  his  objection.   There  being  no  further                                                               
objection,  the   confirmations  for   the  57   appointees  were                                                               
advanced.                                                                                                                       
                                                                                                                                
3:49:14 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:49 p.m. to 3:52 p.m.                                                                       
                                                                                                                                
                                                                                                                                
        HB 170-AK SECURITIES ACT; PENALTIES; CRT. RULES                                                                     
                                                                                                                                
3:52:04 PM                                                                                                                    
                                                                                                                                
CHAIR KITO  announced that  the next order  of business  would be                                                               
HOUSE   BILL   NO.  170,   "An   Act   relating  to   securities,                                                               
registration,  exempt  securities, exempt  transactions,  broker-                                                               
dealers,   agents,   investment  advice,   investment   advisers,                                                               
investment adviser  representatives, federal  covered securities,                                                               
federal   covered   investment  advisers,   viatical   settlement                                                               
interests, small intrastate  security offerings, Canadian broker-                                                               
dealers, and Canadian agents;  relating to administrative, civil,                                                               
and  criminal enforcement  provisions, including  restitution and                                                               
civil penalties for violations;  relating to an investor training                                                               
fund; establishing  increased civil  penalties for  harming older                                                               
persons   and  vulnerable   adults;   relating  to   corporations                                                               
organized  under   the  Alaska  Native  Claims   Settlement  Act;                                                               
amending  Rules 4,  5,  54, 65,  and 90,  Alaska  Rules of  Civil                                                               
Procedure,  and Rule  602, Alaska  Rules of  Appellate Procedure;                                                               
and providing for an effective date."                                                                                           
                                                                                                                                
3:52:56 PM                                                                                                                    
                                                                                                                                
CHAIR KITO,  after ascertaining  that there was  no one  else who                                                               
wished to testify, closed public testimony on HB 170.                                                                           
                                                                                                                                
3:53:13 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL moved to report  HB 170 out of committee with                                                               
individual  recommendations and  the  accompanying fiscal  notes.                                                               
There being  no objection, HB 170  was reported out of  the House                                                               
Labor and Commerce Standing Committee.                                                                                          
                                                                                                                                
3:53:32 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 3:53 p.m. to 3:56 p.m.                                                                       
                                                                                                                                
                HB 103-OPTOMETRY & OPTOMETRISTS                                                                             
                                                                                                                                
[Contains mention of SB 36]                                                                                                     
                                                                                                                                
3:56:34 PM                                                                                                                    
                                                                                                                                
CHAIR KITO  announced that the  final order of business  would be                                                               
HOUSE  BILL  NO.  103,  "An  Act  relating  to  the  practice  of                                                               
optometry."  [Before the committee was CSHB 103(HSS).]                                                                          
                                                                                                                                
3:57:01 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE IVY SPOHNHOLZ, Alaska  State Legislature, as prime                                                               
sponsor, presented HB 103.   She explained that the proposed bill                                                               
would give  authority to the  Board of Examiners in  Optometry to                                                               
regulate  the practice  of optometry;  it would  ensure that  the                                                               
board  has   the  opportunity   to  update   current,  continuing                                                               
education  which is  more  expansive than  those  in policy,  the                                                               
scope of  best practices, and  would allow  the board to  use the                                                               
regulatory process  to manage  itself.   Representative Spohnholz                                                               
would  allow  a  transparent   regulatory  process  ensuring  the                                                               
vetting  of  any  new  board  regulations  with  public  and  the                                                               
Department  of   Law.    The   proposed  bill  would   not  allow                                                               
optometrists  to  provide  services  outside of  their  scope  of                                                               
practice.   Representative  Spohnholz  stated, "My  hope is  this                                                               
will  get  the  legislature  out  of  the  business  of  managing                                                               
optometry."                                                                                                                     
                                                                                                                                
3:58:39 PM                                                                                                                    
                                                                                                                                
BERNICE  NISBETT,  Staff,  Representative Ivy  Spohnholz,  Alaska                                                               
State  Legislature,  presented  a  sectional  analysis  for  CSHB                                                               
103(HSS), on  behalf of Representative Spohnholz,  prime sponsor.                                                               
She drew  attention to the  beginning of the  sectional analysis,                                                               
which read  as follows [original punctuation  provided, with some                                                               
formatting changes]:                                                                                                            
                                                                                                                                
     Section  one  AS.08.72.050   (4)(6)  updates  very  old                                                                    
     statutes to indicate that  regulations shall be adopted                                                                    
     to  govern   the  current   prescription  and   use  of                                                                    
     Pharmaceutical  agents; and  develop uniform  standards                                                                    
     for the practice of optometry.                                                                                             
                                                                                                                                
MS. NISBETT added  that the most significant change  in Section 1                                                               
is  that  the  language  regarding ophthalmic  surgery  and  non-                                                               
invasive  procedures has  been removed  [from  the original  bill                                                               
version].    She  continued  to   Section  2,  described  in  the                                                               
sectional  analysis, as  follows [original  punctuation provided,                                                               
with some formatting changes]:                                                                                                  
                                                                                                                                
     Section  two   AS.08.72.060  (c)(4)  the   board  shall                                                                    
     publish advisory  opinions regarding standards  for the                                                                    
     practice of optometry.                                                                                                     
                                                                                                                                
MS. NISBETT included  that the sponsor of the bill  would like to                                                               
add an amendment  to tighten up the language  and would introduce                                                               
the amendment at a  later date.  She pointed to  page 1, line 13,                                                               
and explained  that "sec.11, ch.25,  SLA" refers to  the Medicaid                                                               
Reform  Bill  that was  passed  in  2016.    She noted  that  "AS                                                               
17.30.200(o)" also refers to the Medicaid Reform Bill.                                                                          
                                                                                                                                
MS. NISBETT  highlighted the remaining  portion of  the sectional                                                               
analysis, which  read as follows [original  punctuation provided,                                                               
with some formatting changes]:                                                                                                  
                                                                                                                                
     Section  three  AS  08.72.181(d) moves  the  continuing                                                                    
     education  (CE) requirements  back into  regulation, as                                                                    
     desired  by the  Department  of  Commerce, Community  &                                                                    
     Economic  Development.   Continuing education  is still                                                                    
     required  by   current  statute,  but  the   hours  and                                                                    
     subjects will be determined by the board.                                                                                  
                                                                                                                                
     Section  four  AS  08.72.272(a) clarifies  the  current                                                                    
     statute for the board  to regulate pharmaceutical agent                                                                    
     prescription  including  standards and  limitations  on                                                                    
     practice determined by the board.                                                                                          
                                                                                                                                
     Section five  AS 08.72.278 Limitation on  practice adds                                                                    
     a  new  section  that  sets  limitations  on  services,                                                                    
     ensuring  that   the  board   may  not   authorize  any                                                                    
     procedure beyond the scope  of the licensee's education                                                                    
     and experience.                                                                                                            
                                                                                                                                
     Section  six  AS  08.72.300(3)  updates  the  optometry                                                                    
     definition to reflect current practice.                                                                                    
                                                                                                                                
     Section  seven Effective  date for  Section 2.  This is                                                                    
     because  (3) of  Section two  was added  to statute  in                                                                    
     2016 via Senate Bill 74,  the Medicaid Reform bill, and                                                                    
     it  had the  effective date  of  July 2017,  so (4)  is                                                                    
     written  to  comply  with  that   date  as  well.  (per                                                                    
     Legislative Drafting)                                                                                                      
                                                                                                                                
4:01:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WOOL requested  the  information  on the  omitted                                                               
procedures in Section 1.                                                                                                        
                                                                                                                                
MS.  NISBETT  stated  that  the language  in  the  original  bill                                                               
version that  was removed  under the  CS pertained  to ophthalmic                                                               
surgery.                                                                                                                        
                                                                                                                                
4:02:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SPOHNHOLZ emphasized  that  to define  ophthalmic                                                               
surgery in a  way that made a clear statute  is challenging; this                                                               
resulted in the  language being taken out in the  bill.  She said                                                               
that  the word  "surgery"  has  a very  specific  meaning to  the                                                               
average person but  is a broadly used term in  the medical field.                                                               
She shared  that she had  had a  small foreign body  removed from                                                               
her  left eye  and how  that meets  the definition  of ophthalmic                                                               
surgery.   She  said she  doesn't want  to "split  hairs" in  the                                                               
statute but instead  leave the authority to the  board to develop                                                               
uniform  standards of  practice  for  optometry.   Representative                                                               
Spohnholz  stated this  won't  give the  board  the authority  to                                                               
allow for surgeries  that are outside of [a  licensee's] scope of                                                               
practice.   She stated  that [the board]  needs to  find language                                                               
that will be relevant after a few  years.  She gave an example of                                                               
the language that isn't durable on  page 2, section 3, which is a                                                               
whole  section describing  a timeframe  for continuing  education                                                               
that  is  not  as  aggressive  as  the  board's  regulations  for                                                               
continuing  education.     Representative   Spohnholz  encouraged                                                               
allowing the  board to regulate  itself as regularly as  it would                                                               
like, without having  to bring requests for minor  changes to the                                                               
legislature.                                                                                                                    
                                                                                                                                
4:05:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON  asked  who determines  the  background                                                               
requirements  for  optometry  practices regarding  education  and                                                               
training.                                                                                                                       
                                                                                                                                
REPRESENTATIVE SPOHNHOLZ  responded both  the Board  of Examiners                                                               
in Optometry and the Department of Law.                                                                                         
                                                                                                                                
4:05:46 PM                                                                                                                    
                                                                                                                                
MS.  NESBITT,  in  response to  a  question  from  Representative                                                               
Knopp, explained that the sponsor  intends to change the language                                                               
on page 2, line 6, of CSHB 103(HSS), which read as follows:                                                                     
                                                                                                                                
     (4) publish advisory opinions regarding standards for                                                                  
     the practice seven of optometry as provided under this                                                                 
     chapter.                                                                                                               
                                                                                                                                
MS. NESBITT  said [the  bill sponsor] would  like to  change that                                                               
language  to read  as  in the  statute for  the  Alaska Board  of                                                               
Nursing, AS 08.68.100(a)(9), which read as follows:                                                                             
                                                                                                                                
     (9)   publish  advisory   opinions  regarding   whether                                                                    
     nursing  practice procedures  or  policies comply  with                                                                    
     acceptable  standards of  nursing  practice as  defined                                                                    
     under this chapter;                                                                                                        
                                                                                                                                
MS. NESBITT noted that "optometric" would replace "nursing".                                                                    
                                                                                                                                
REPRESENTATIVE  KNOPP expressed  his approval  of the  bill.   He                                                               
said  Ms.  Nesbitt, in  presenting  the  sectional analysis,  had                                                               
addressed any  concerns he  had regarding  optometrists operating                                                               
"within the limits of their training."                                                                                          
                                                                                                                                
4:08:29 PM                                                                                                                    
                                                                                                                                
HARRIET MILKS,  Assistant Attorney  General, Commercial  and Fair                                                               
Business  Section,  Civil  Division, Juneau,  Department  of  Law                                                               
(DOL), said that she represented professional licensing boards.                                                                 
                                                                                                                                
4:08:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON  related that  Ms. Nesbitt had  told him                                                               
that [the bill  sponsor's] office would not  "intervene on policy                                                               
or comment on  how the board regulates itself."   He asked if the                                                               
Department  of  Law  has  the   authority  to  determine  whether                                                               
optometrists have the necessary training to "do 'X'."                                                                           
                                                                                                                                
MS. MILKS responded,  "Absolutely, that is our role,  and the way                                                               
we  do  that is  we  look  very carefully  at  the  scope of  the                                                               
statutory authority  that you  would give  the board,  and that's                                                               
our  starting point."    She  explained that  at  that point  the                                                               
Department  of  Law   would  advise  the  board   if  a  proposed                                                               
regulation goes beyond the scope of the statutory authority.                                                                    
                                                                                                                                
REPRESENTATIVE   JOSEPHSON   shared    his   understanding   that                                                               
ophthalmologists  have concerns  that  under  the proposed  bill,                                                               
optometrists would  be able to  define what treatment means.   He                                                               
asked whether the  department has any authority  over the board's                                                               
decisions regarding treatment being within  the scope of field of                                                               
optometry.                                                                                                                      
                                                                                                                                
4:10:57 PM                                                                                                                    
                                                                                                                                
MS. MILKS  responded that it  "can be  a delicate balance."   She                                                               
said the Department of Law  doesn't make judgements or substitute                                                               
its  vision  of what  the  policy  should  be;  it looks  at  the                                                               
language of the statute.                                                                                                        
                                                                                                                                
4:12:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE BIRCH  asked how the  Good Samaritan Law  would be                                                               
affected by  CSHB 103 (HSS).   He related that in  rural areas of                                                               
the  state, dentists,  veterinarians, and  physicians often  help                                                               
outside their field of practice.   Representative Birch offered a                                                               
hypothetical example of  an individual getting a  fish hook stuck                                                               
in his/her  eye, and the only  person in town that  could help is                                                               
an optometrist.                                                                                                                 
                                                                                                                                
MS.  MILKS  responded  she  would   have  to  research  the  Good                                                               
Samaritan Law  and get  back to  the committee.   She  added that                                                               
optometrists have authority to remove fish hooks.                                                                               
                                                                                                                                
REPRESENTATIVE  BIRCH  stated many  rural  areas  in Alaska  have                                                               
incidences that  would be affected  by the  proposal legislation,                                                               
and he stated that he is interested in the topic.                                                                               
                                                                                                                                
4:14:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD asked Ms.  Milks if she was aware                                                               
of a  court case where there  had been a challenge  regarding the                                                               
prescribed duties of optometrists versus ophthalmologists.                                                                      
                                                                                                                                
MS. MILKS replied that she was not familiar with any.                                                                           
                                                                                                                                
4:15:23 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WOOL   referred  to   Representative  Spohnholz's                                                               
example that  having a small  foreign body  taken out of  her eye                                                               
would constitute surgery.  He  implied that the definition "would                                                               
make a lot of layman surgeons."   He questioned if the definition                                                               
for surgery  would need to be  in statute, how the  Department of                                                               
Law  defined the  terms,  and  if the  Department  of Law  needed                                                               
direction through statute over words like surgery.                                                                              
                                                                                                                                
MS. MILKS  stated the Department  of Law refers to  sources, such                                                               
as statute  and the  board, and the  board seeks  public comment.                                                               
She said, "What we don't do is make it up."                                                                                     
                                                                                                                                
4:17:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KNOPP asked for Ms.  Milks' thoughts on whether an                                                               
optometrist is  equally qualified  to do what  an ophthalmologist                                                               
does.                                                                                                                           
                                                                                                                                
MS. MILKS stated she did not have an opinion on that question.                                                                  
                                                                                                                                
4:17:47 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SPOHNHOLZ cited  current  statute, AS  08.72.273,                                                               
which reads as follows:                                                                                                         
                                                                                                                                
     Removal  of  foreign  bodies.  A  licensee  may  remove                                                                    
     superficial  foreign  bodies  from   the  eye  and  its                                                                    
     appendages. This  section is  not intended to  permit a                                                                    
     licensee to perform invasive surgery.                                                                                      
                                                                                                                                
She explained that she had  read this statutory language to avoid                                                               
[the committee discussion] "going down the rabbit hole."                                                                        
                                                                                                                                
4:18:48 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON  expressed  his concern  regarding  the                                                               
ongoing dispute  between the two  professions, and he  stated his                                                               
presumption that the debate will shift to the board.                                                                            
                                                                                                                                
4:20:02 PM                                                                                                                    
                                                                                                                                
MS.  MILKS answered  that the  Department of  Law provides  legal                                                               
advice  at  every  public  meeting   if  the  board  requests  an                                                               
attorney.   She stated that  she can't predict what  would happen                                                               
between the two professions.                                                                                                    
                                                                                                                                
REPRESENTATIVE JOSEPHSON stated the  previous version of the bill                                                               
that suggested  an interest  in optometrists  performing surgery.                                                               
He opined that  there would have to be "a  day of reckoning where                                                               
some surgeries  will be allowed,  and some  won't."  He  asked if                                                               
the proposed bill  would resolve this or if it  would be resolved                                                               
at a different date.                                                                                                            
                                                                                                                                
MS. MILKS deferred to the bill sponsor.                                                                                         
                                                                                                                                
4:21:48 PM                                                                                                                    
                                                                                                                                
CHAIR KITO opened public testimony on HB 103.                                                                                   
                                                                                                                                
4:22:08 PM                                                                                                                    
                                                                                                                                
PAUL  BARNEY,  MD,  Chair,  Board   of  Examiners  on  Optometry,                                                               
Division of  Corporations, Business, and  Professional Licensing,                                                               
Department   of  Commerce,   Community  &   Economic  Development                                                               
(DCCED), testified in support of HB 103.   He noted that he is an                                                               
optometrist  and   past  president   of  the   Alaska  Optometric                                                               
Association,  who has  practiced for  the  last 17  years as  the                                                               
center  director  of the  Pacific  Cataract  and Laser  Institute                                                               
(PCLI),  which  is  a  referral center  limited  to  medical  and                                                               
surgical eye care.  He continued as follows:                                                                                    
                                                                                                                                
     I  practice with  an  ophthalmologist  and a  certified                                                                    
     registered  nurse anesthetist.    Our  approach to  eye                                                                    
     care  is to  approach it  as a  team and  optimize each                                                                    
     practitioner's  education and  skills.   I bring  up my                                                                    
     mode  of practice  with other  eye care  professionals,                                                                    
     because by  practicing to our fullest  potential, we're                                                                    
     able to provide quality,  more affordable, surgical eye                                                                    
     care for  Alaskans.  In  fact, we are  largest provider                                                                    
     of cataract care in the state of Alaska.                                                                                   
                                                                                                                                
     I  support HB  103, because  it'll allow  the Board  of                                                                    
     [Examiners  on] Optometry  to regulate  the details  of                                                                    
     the  practice  of  optometry.    This  is  how  advance                                                                    
     practice  nurses,  dentists,  and medical  doctors  are                                                                    
     regulated in Alaska.  With  that said, this legislation                                                                    
     will not  set a new  [precedent] in healthcare  ... and                                                                    
     will not  be a risk  to Alaskans since this  is already                                                                    
     the way  other health  care providers are  regulated in                                                                    
     Alaska.     HB  103   will  give   optometrists  better                                                                    
     opportunity to  practice at the highest  level of their                                                                    
     education  by  allowing  the Board  of  [Examiners  on]                                                                    
     Optometry  to write  regulations that  are commensurate                                                                    
     with   educational  advances   that   occur  with   new                                                                    
     technology.  The current  optometry statute was written                                                                    
     over 40  years ago and  requires optometry to  pursue a                                                                    
     statute   change  whenever   there   are  advances   in                                                                    
     education  and  technology.     As  you  know,  statute                                                                    
     changes are costly and time consuming.                                                                                     
                                                                                                                                
     Like  other professional  regulatory boards,  the Board                                                                    
     of   [Examiners   on]   Optometry   cannot   promulgate                                                                    
     regulations  for  practices   or  procedures  that  are                                                                    
     beyond  the education  of optometrists.   The  Board of                                                                    
     [Examiners on] Optometry is  overseen by the Department                                                                    
     of  Law, just  like  other healthcare  boards, and  the                                                                    
     Alaska Department  of Law would  ensure that  the Board                                                                    
     of [Examiners  on] Optometry's regulations  were within                                                                    
     the scope of optometric education.                                                                                         
                                                                                                                                
     Other  safeguards  are  our medical  legal  system  and                                                                    
     insurance   system.     Any  healthcare   provider  who                                                                    
     provides care outside of their  education is subject to                                                                    
     disciplinary action by their  respective board, as well                                                                    
     as serious medical  legal ramifications.  Additionally,                                                                    
     insurance carriers  do not pay providers  for care that                                                                    
     they provide  outside their scope  of education.   As a                                                                    
     result,  there's   no  incentive  for   any  healthcare                                                                    
     provider to  provide care  outside of  their education,                                                                    
     and   there  are   very   serious  consequences,   both                                                                    
     financially  and to  their licensure,  to practitioners                                                                    
     that do provide care outside of their education.                                                                           
                                                                                                                                
     As  chair  of  the   Alaska  Board  of  [Examiners  on]                                                                    
     Optometry, I  can assure you  that the  primary concern                                                                    
     of the board  is the safety of the public.   In the six                                                                    
     years  that I've  served  on the  board,  we've had  no                                                                    
     complaints  from the  public that  were serious  enough                                                                    
     that   they   even  considered   disciplinary   action.                                                                    
     Optometrists,   in   general,  are   conservative   and                                                                    
     cautious  practitioners,  and  the passage  of  HB  103                                                                    
     would not change their conservative nature.                                                                                
                                                                                                                                
     HB 103  would be  good for  the state  of Alaska.   The                                                                    
     bill   puts  the   regulatory  details   regarding  the                                                                    
     practice of optometry in the  authority of the Board of                                                                    
     [Examiners on] Optometry.   These changes are important                                                                    
     to allow  the profession  and practice of  optometry to                                                                    
     incorporate  new technologies  and advances  in eyecare                                                                    
     as  they occur.   Optometry  provides approximately  70                                                                    
     percent  of the  eye care  in  the U.S.,  and in  rural                                                                    
     areas, especially  in Alaska,  they often are  the only                                                                    
     eye care  provider in the  community.  The  citizens of                                                                    
     Alaska deserve  to be  served by  a profession  that is                                                                    
     allowed to stay current  with advances in education and                                                                    
     new technology.                                                                                                            
                                                                                                                                
DR. BARNEY  concluded his  testimony by  urging the  committee to                                                               
support HB 103.                                                                                                                 
                                                                                                                                
4:26:31 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE BIRCH asked  how optometrists and ophthalmologists                                                               
"do a hand-off" with their patients.                                                                                            
                                                                                                                                
MR. BARNEY  answered that optometrists and  ophthalmologists work                                                               
well together.   He  stated that  the two  professions understand                                                               
each other's  potential and know  what statutory authority  is in                                                               
each profession.                                                                                                                
                                                                                                                                
4:27:56 PM                                                                                                                    
                                                                                                                                
JILL  GEERING  MATHESON,  OD, Alaskan  Vision  Center  Optometry,                                                               
testified  in support  of HB  103.   She related  that she  was a                                                               
former  chair  of the  Board  of  Examiners  in Optometry.    She                                                               
continued, as follows:                                                                                                          
                                                                                                                                
     Over 25  years, I have testified  numerous times before                                                                    
     this  committee and  many other  legislative committees                                                                    
     in  support   of  changes   to  the   Alaska  Optometry                                                                    
     statutes,  and  these  have been  successful  over  the                                                                    
     years.  This is due to  the level of trust that the ...                                                                    
     legislators  have   given  optometrists  in   spite  of                                                                    
     rhetoric saying that we were going to harm people.                                                                         
                                                                                                                                
     Now I  come before you not  to argue safety or  get the                                                                    
     efficacy  of  treatment  options  that need  to  be  in                                                                    
     statute but to  ask for your support for  HB 103, which                                                                    
     gives  the  Board  [of   Examiners  in  Optometry]  the                                                                    
     authority  to  regulate  optometrists.    Just  as  the                                                                    
     people of  Alaska elect  all of  you to  represent them                                                                    
     honestly, safely,  and responsibly, the members  of the                                                                    
     state   boards  and   commissions  are   appointed  and                                                                    
     confirmed  by  the legislature  to  do  the same  under                                                                    
     their  various areas  of expertise.   The  days of  the                                                                    
     medical  board's being  the  holy  grail of  overseeing                                                                    
     every health profession are long gone.                                                                                     
                                                                                                                                
     Alaska  chose  to  set  up  separate  boards  for  each                                                                    
     profession  because  each  profession  is  unique,  and                                                                    
     Alaska  saw that  the  oversite  for those  professions                                                                    
     needed to be handled by  those members.  So, the people                                                                    
     of  Alaska -  through the  legislature -  have approved                                                                    
     statutes  that are  very  broad to  many  of the  other                                                                    
     health  boards,  and  these  boards  are  now  able  to                                                                    
     autonomously  manage their  respected profession  in an                                                                    
     honest, safe,  and responsible  manner.   The optometry                                                                    
     statute,   on  the   other  hand,   is  currently   too                                                                    
     complicated and restrictive.  All  HB 103 does is allow                                                                    
     the state Board  of Examiners in Optometry  to have the                                                                    
     same autonomy.                                                                                                             
                                                                                                                                
DR.  GEERING MATHESON  said HB  103 is  not about  "eye surgery,"                                                               
which she said is  a buzz term used by the  opposition as a scare                                                               
tactic.  She  said she was licensed 25 years  ago, and Doctors of                                                               
Optometry  are trained  to  do minor  surgeries  that are  within                                                               
their scope of  practice.  She said she would  no more conduct an                                                               
eye surgery  she was  not qualified  to do  than would  a dentist                                                               
perform jaw reconstruction, a nurse  perform spinal surgery, or a                                                               
physician perform  neural surgery.   She  stated her  belief that                                                               
the world must  evolve and that professions change.   She stated,                                                               
"There is  no way to  predict what  tools or treatment  options a                                                               
Doctor of  Optometry will need  twenty years from now  to protect                                                               
or cure  the eyes and vision  of a patient."   She explained this                                                               
is why  HB 103 is  written with such  broad language -  "to allow                                                               
for  updates  as  things advance"  and  encompass  "unforeseeable                                                               
changes  in technology."   She  said  she trusts  members of  the                                                               
Board  of  Examiners  of  Optometry to  make  and  oversee  those                                                               
changes.                                                                                                                        
                                                                                                                                
4:31:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD asked  for examples of continuing                                                               
education units (CEUs)  that would broaden the  scope of practice                                                               
[within the field of optometry].                                                                                                
                                                                                                                                
DR.  MATHESON answered  that CEUs  are unforeseen.   She  gave an                                                               
example  from  other states  of  minor  surgical procedures  that                                                               
Alaska doesn't do, like laser procedures.                                                                                       
                                                                                                                                
4:32:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KNOPP  said the state  and board mandates  are for                                                               
the timeline for completion of CEUs for an optometrist.                                                                         
                                                                                                                                
DR.  MATHESON answered  that under  regulation, optometrists  are                                                               
required  to  complete  18  hours  every  year.    She  said  the                                                               
licensing period  is two  years, so the  total requirement  is 36                                                               
hours  during each  licensing period.    The 36-hour  requirement                                                               
under regulation is more than  the current statutory requirement,                                                               
which is eight hours.                                                                                                           
                                                                                                                                
REPRESENTATIVE KNOPP asked what  credentials optometrists need to                                                               
get and how many years it takes them to get certified.                                                                          
                                                                                                                                
DR.  MATHESON  answered  four  years  undergraduate,  four  years                                                               
optometry school, and then optional residencies.                                                                                
                                                                                                                                
REPRESENTATIVE  KNOPP mentioned  that  some ophthalmologists  are                                                               
certified in laser procedures while  others are not, and he asked                                                               
if there have been recent changes with that issue.                                                                              
                                                                                                                                
DR. MATHESON indicated she did not know.                                                                                        
                                                                                                                                
4:34:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL referenced feedback  his office received that                                                               
highlights a  difference of opinion between  ophthalmologists and                                                               
optometrists  as to  what optometrist  are qualified  to do.   He                                                               
then asked if continuing education counts as "basic training."                                                                  
                                                                                                                                
4:36:01 PM                                                                                                                    
                                                                                                                                
DR. MATHESON answered that if  the board allowed a new procedure,                                                               
then there  would be required  training that would go  along with                                                               
that new  procedure.  She gave  an example of what  has been done                                                               
in  the  past  with  new  procedures  and  the  number  of  hours                                                               
optometrists have  had to  complete before  they were  allowed to                                                               
perform that procedure.                                                                                                         
                                                                                                                                
4:37:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WOOL  gave an  example  of  dental hygienists  in                                                               
other states  administering Novocain  injections, which  20 years                                                               
ago may  not have happened.   He asked what the  process would be                                                               
for the board to allow changes.                                                                                                 
                                                                                                                                
DR. MATHESON answered that all  medical professionals must meet a                                                               
standard  of care  and all  are  held to  high standards  through                                                               
their education.                                                                                                                
                                                                                                                                
4:38:41 PM                                                                                                                    
                                                                                                                                
SCOTT LIMSTROM,  MD, President, Alaska Society  of Eye Physicians                                                               
and Surgeons (ASEPS),  stated that HB 103 and  its companion bill                                                               
SB 36  are opposed by  the Alaska  Society of Eye  Physicians and                                                               
Surgeons, the  State of  Alaska Board  of Medical  Examiners, the                                                               
Alaska  State Medical  Association, and  the American  Academy of                                                               
Ophthalmology.  He stated that  the controversy with the proposed                                                               
legislation  is that  it  would  allow non-medical  professionals                                                               
unrestricted ability to prescribe all  scheduled drugs.  He said,                                                               
as an  ophthalmologist, he rarely  prescribes narcotics  for pain                                                               
control.  He spoke of the  epidemic in Alaska resulting in deaths                                                               
from overdoses of narcotics.                                                                                                    
                                                                                                                                
4:40:38 PM                                                                                                                    
                                                                                                                                
DR. LIMSTROM  opined that HB 103  and SB 36, as  written, are the                                                               
most expansive scope of practice bills  in the nation.  He stated                                                               
that  the   proposed  legislation  would  give   the  board  full                                                               
authority to  determine which invasive, diagnostic,  and surgical                                                               
procedures ophthalmologists  may perform  on patient's eyes.   He                                                               
noted that  there are no  doctors or surgeons  on the board.   In                                                               
response  to a  previous  remark  by the  bill  sponsor that  the                                                               
attorney  general would  be scrutinizing  the regulations  of the                                                               
board, he  questioned what the attorney  general's qualifications                                                               
are on  eye surgery.   He referenced  the State of  Washington as                                                               
having  very  clear  law  defining  eye  surgery.    In  the  law                                                               
optometrists  are  prohibited  from   performing  surgery.    Dr.                                                               
Limstrom  said ASEPS  requests clear  definition of  eye surgery.                                                               
He opined  that for the safety  of [Alaskans], HB 103  should not                                                               
move forward.                                                                                                                   
                                                                                                                                
4:41:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KNOPP  asked if prescribing drugs  will be covered                                                               
under continuing education requirements.                                                                                        
                                                                                                                                
DR.  LIMSTROM  stated  the bill  gives  unrestricted  ability  to                                                               
prescribe all scheduled drugs.                                                                                                  
                                                                                                                                
REPRESENTATIVE  KNOPP noted  that  Dr. Limstrom  had requested  a                                                               
clear  definition of  eye  surgery.   He  questioned whether  Dr.                                                               
Limstrom  felt  description  of  the  educational  experience  of                                                               
optometrists was insufficient.                                                                                                  
                                                                                                                                
DR.  LIMSTROM  answered  no,  he doesn't.    He  referenced  that                                                               
Washington  State  enacted  a  definition many  years  ago.    He                                                               
expressed concern that the current  bill could leave the board to                                                               
define what [optometrists] can and  can't do and dictate what the                                                               
education requirements are.                                                                                                     
                                                                                                                                
4:44:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE BIRCH asked  if dentists and nurses  have the same                                                               
authority as ophthalmologists for prescribing narcotics.                                                                        
                                                                                                                                
DR. LIMSTROM stated he isn't  familiar with what authority nurses                                                               
and   dentists  have.     The   requirements   for  becoming   an                                                               
ophthalmologist, as  a medical doctor,  include going  to medical                                                               
school, serving internships,  and undergoing fellowship training.                                                               
He   explained  his   ability   subscribe   all  five   scheduled                                                               
medications but  said the strongest medication  he prescribes, as                                                               
a  physician,  is hydrocodone  and  rarely  his prescriptions  go                                                               
beyond three  to four days  post operation.  Dr.  Limstrom stated                                                               
that  the reason  these medications  are restricted  is that  the                                                               
more prescriptions are written, the  more abuse will occur in the                                                               
general public.  So, when  the Food and Drug Administration (FDA)                                                               
and   the  Drug   Enforcement  Administration   (DEA)  restricted                                                               
[prescribing ability],  it caused  a reduction  in the  number of                                                               
prescriptions being written.                                                                                                    
                                                                                                                                
4:45:18 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON  asked  what ophthalmic  surgeries  are                                                               
acceptable for optometrists to get trained on and perform.                                                                      
                                                                                                                                
DR.  LIMSTROM stated  that Representative  Josephson would  get a                                                               
different answer  regarding what is acceptable  and unacceptable,                                                               
depending  on  whom  he  asks.     He  affirmed  that  there  are                                                               
procedures  that optometrists  are  allowed to  perform and  that                                                               
there are more  procedures that optometrists are  capable of with                                                               
the proper  training.  He questioned  if it is necessary  or safe                                                               
for the public.  He said a  person who wants to perform a surgery                                                               
with  general  anesthesia  has  to  go to  medical  school.    He                                                               
asserted that as  an ophthalmologist, the procedures  he does are                                                               
complicated, and many require generalized  anesthesia.  He warned                                                               
that the danger  of HB 103 is that the  optometrists have not had                                                               
[the same level of] training.                                                                                                   
                                                                                                                                
4:47:31 PM                                                                                                                    
                                                                                                                                
EVAN WOLF,  MD, Wolf  Eye Center, testified  in opposition  to HB                                                               
103.  He  said he has been  in practice for 15 years.   He opined                                                               
that the  proposed bill is  the most expansive scope  of practice                                                               
bill  in   the  country.     He  referenced   Washington  State's                                                               
legislation,  which  established a  definition  on  the scope  of                                                               
practice for optometry, the definition  of surgery, and a list of                                                               
procedures  that aren't  considered  surgical and,  thus, can  be                                                               
done by  an optometrist  in the  clinic.   He cited  a Washington                                                               
State statute labeled  RCW 18.53.010, Section 8,  which he opined                                                               
would be a  good reference for Alaska lawmakers.   Dr. Wolf cited                                                               
Malcolm Gladwell's  book, Outliers.   The book theorizes  that it                                                             
takes  10,000  hours  to  become  an  expert  in  anything.    He                                                               
explained how  this theory relates  to surgical  knowledge, since                                                               
it took  him 26,000 hours  of training  to use laser  and perform                                                               
cataract  surgery safely.   He  stated that  the training  for an                                                               
optometrist would  be about  8,000 hours. Dr.  Wolf cited  a 2016                                                               
Journal  of America  Medical Association  (JAMA) study,  in which                                                             
Joshua  Dr.  Stein,  MD,  MS,   discovered  what  happens  if  an                                                               
optometrists and ophthalmologist perform  the same procedures, in                                                               
states like  Kentucky and Oklahoma  where optometrists  are doing                                                               
basic laser procedures.  The  study asked what the outcomes would                                                               
be if  they compared optometrists  or ophthalmologists  doing the                                                               
same procedures.  Dr. Wolf  said the study showed that worst-case                                                               
scenario is that  the procedure needs to be repeated.   The study                                                               
found that  procedures performed  by optometrists were  2.3 times                                                               
more likely  to need to  be repeated compared to  those performed                                                               
by ophthalmologists.                                                                                                            
                                                                                                                                
4:52:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WOOL  asked  if  Dr. Wolf  did  26,000  hours  of                                                               
training before performing an unaccompanied surgery.                                                                            
                                                                                                                                
DR.  WOLF  answered  by  stating his  26,000  hours  of  training                                                               
included medical school and residency.   Residency is a four-year                                                               
process of  learning, including  basic surgeries  and development                                                               
of knowledge and vocabulary.                                                                                                    
                                                                                                                                
REPRESENTATIVE  WOOL   asked  if   Dr.  Wolf's   overall  medical                                                               
education of eight years was not specifically surgery training.                                                                 
                                                                                                                                
DR. WOLF  broke down the hours  of training he obtained:   12,000                                                               
hours  of  medical training  and  14,000  hours of  ophthalmology                                                               
training.                                                                                                                       
                                                                                                                                
4:53:54 PM                                                                                                                    
                                                                                                                                
ERIK  CHRISTIANSON, OD,  testified  in  support of  HB  103.   He                                                               
stated  that   as  the  only   medically  based   optometrist  in                                                               
Ketchikan, he  sees how HB 103  could benefit his community.   He                                                               
already performs  minor surgeries  every day and  refers patients                                                               
to  ophthalmologists for  complex surgeries.   His  community and                                                               
the communities  around him only have  access to ophthalmologists                                                               
who rotate  through; it  can be tough  to get  an ophthalmologist                                                               
because of travel restraints.   Dr. Christianson said he knows of                                                               
patients  performing minor  procedures on  themselves because  of                                                               
the  lack  of  medically  trained  individuals  available.    Dr.                                                               
Christianson  is  asking  [the   legislature]  to  modernize  the                                                               
optometry statute  so that  optometrists are  "able to  do things                                                               
within our training."                                                                                                           
                                                                                                                                
4:57:56 PM                                                                                                                    
                                                                                                                                
MATTHEW  GUESS,  MD, testified  in  opposition  to  HB 103.    He                                                               
expressed concern  that under HB  103, the Board of  Examiners in                                                               
Optometry  could  self-regulate  its   scope  of  practice,  thus                                                               
allowing  invasive procedures  in or  around the  eye, for  which                                                               
optometrists  have received  no meaningful  formal training.   He                                                               
referenced  earlier  testimony  by  Dr.  Matheson,  in  which  he                                                               
indicated  that part  of  ophthalmologists' continuing  education                                                               
required   seven  hours   of   injection   training  for   eyelid                                                               
procedures.     He  said  he   spent  time  in   medical  school,                                                               
residencies, and  two extra  years of  training in  a fellowship,                                                               
and he  learned to both  diagnose and  treat diseases of  the eye                                                               
with  operative  procedures  and  operative  invasive  surgeries.                                                               
During that time,  he spent two years in a  fellowship, worked 55                                                               
to 65  hours per  week, examined tens  of thousands  of patients,                                                               
and  performed  thousands  of surgeries  under  the  guidance  of                                                               
experienced mentors.   He stated there is no  substitute for this                                                               
training; the training allows him  to provide diagnoses treatment                                                               
and  perform  procedures and  surgeries  in  the safest  possible                                                               
manner for  patients.  He stated  that seven hours of  training a                                                               
year  sounds  like  a  minimal   amount  of  work  to  learn  new                                                               
procedures or stay current on the procedures that are available.                                                                
                                                                                                                                
5:00:24 PM                                                                                                                    
                                                                                                                                
KELLY LORENZ, MD, testified in  opposition to 103.  She expressed                                                               
concern over the vague wording of  HB 103 and stated the proposed                                                               
bill would  support optometrists performing procedures  that they                                                               
are not  adequately trained to  do, including:  several  types of                                                               
laser  procedures; eyelid  surgery, including  eye lifts;  limbal                                                               
relaxing incisions;  and many other  procedures.  She  stated her                                                               
concern that  "a couple weekend  courses at  a local hotel  by an                                                               
optometrist will  not make up  for years of surgical  training by                                                               
an ophthalmologist."   She stated  that the bill would  lower the                                                               
standards  of surgical  care in  Alaska.   She shared  statistics                                                               
that 90 percent of people polled  stated they would rather have a                                                               
medical doctor performing a surgery.                                                                                            
                                                                                                                                
5:03:30 PM                                                                                                                    
                                                                                                                                
STEVE DOBSON,  OD, testified in  support of HB  103.  He  said he                                                               
has   answers  for   all  the   questions  he   heard  from   the                                                               
ophthalmologists that  had testified.   He said he  thinks either                                                               
there   is  intent   to   mislead  or,   perhaps,   there  is   a                                                               
misunderstanding of the  intent of the proposed  legislation.  He                                                               
stated that  HB 103 is  not about  surgery but, for  some reason,                                                               
organized  ophthalmology has  turned it  into "a  surgical bill."                                                               
He said  HB 103  is about board  autonomy and  about optometrists                                                               
practicing at the  highest level for which they are  trained.  He                                                               
indicated  that malpractice  is the  same in  those states  [that                                                               
allow optometrists]  to perform  minor procedures, such  as minor                                                               
laser  procedures, as  it is  in Alaska,  and he  emphasized that                                                               
"insurance  companies  understand  risk."    Dr.  Dobson  stated,                                                               
"Obviously optometrists  are doing  what they  trained to  do and                                                               
nothing more."   He continued, "Optometrists are  trained in very                                                               
few of the  procedures that ophthalmologists do.  I  think we all                                                               
agree with  that.  And  that's not what  we're trying to  do, and                                                               
it's actually  not what this  legislation is about."   Dr. Dobson                                                               
stressed  the  importance of  what  ophthalmologists  do, and  he                                                               
reiterated  that  there  is  little  crossover  between  the  two                                                               
professions.    He proffered  that  if  dentists and  nurses  can                                                               
maintain  their  own boards,  then  it's  time optometrists  were                                                               
given the respect  and consideration to regulate  themselves.  He                                                               
said [this  issue] has been  repeated before the  legislature for                                                               
years, with  the same arguments  given by  ophthalmologists, whom                                                               
he  said  vehemently  oppose  the  recognition  of  "any  of  the                                                               
advances in optometric care."                                                                                                   
                                                                                                                                
5:08:25 PM                                                                                                                    
                                                                                                                                
CHAIR KITO announced that HB 103 was held over.                                                                                 
                                                                                                                                
5:09:04 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Labor and Commerce Standing Committee meeting was adjourned at                                                                  
5:09 p.m.                                                                                                                       
                                                                                                                                

Document Name Date/Time Subjects
HB 103 Fiscal Note DCCED-DCBPL 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103
HB103 Explanation of Changes 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103
HB0103 ver J 3.22.17.PDF HL&C 3/27/2017 3:15:00 PM
HB 103
HB103 Sectional Analysis 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103
HB103 Sponsor Statement 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103
HB103 Supporting Documents-Board of Examiners in Optometry 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103
HB103 Supporting Documents-Career Guide Optometry 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103
HB103 Supporting Documents-Letters of Opposition 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103
HB103 Supporting Documents-Letters of Support 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103
HB103 Supporting Documents-Medical Liability Premiums Fact Sheet 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103
HB103 Supporting Documents-Ohio State Optometry Curriculum 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103
HB103 Supporting Documents-Optometrists Practicing in AK 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103
HB103 Supporting Documents-Optometry Education Flyer 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103
HB103 Supporting Documents-Regulation Flow Chart 3.20.17.pdf HL&C 3/27/2017 3:15:00 PM
HB 103