Legislature(2023 - 2024)BELTZ 105 (TSBldg)
05/01/2024 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB237 | |
| HB97 | |
| HB29 | |
| HB309 | |
| HB254 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 237 | TELECONFERENCED | |
| += | HB 97 | TELECONFERENCED | |
| += | HB 29 | TELECONFERENCED | |
| *+ | HB 226 | TELECONFERENCED | |
| *+ | HB 309 | TELECONFERENCED | |
| *+ | HB 285 | TELECONFERENCED | |
| *+ | HB 254 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
HB 309-DELEGATION OF ROUTINE OPTOMETRY SERVICES
4:20:18 PM
CHAIR BJORKMAN announced the consideration of HOUSE BILL NO. 309
"An Act relating to the practice of optometry; and relating to
the delegation of routine services of optometry."
4:20:55 PM
JAMES SEXTON, Staff, Representative Justin Ruffridge, Alaska
State Legislature, Juneau, Alaska, gave a brief overview of HB
309 and it's beneficial impacts on optometry practices.
[Original punctuation provided.]
MR. SEXTON moved to slide 2, and explained that a review of
optometric practices revealed that there was not statutory
language allowing delegation of optometric tasks.
Issue
• Optometric practices do not have current statute
language to allow the Board of Examiners of
Optometry to regulate delegation of routine tasks to
Optometric Technicians and Assistants
• Delegation of basic routine tasks are standard
practice in other health professions licensed in
Alaska, as well as optometric practices nationwide
• Without this authority, Optometrists would be
required to perform all preliminary and ancillary
testing on each patient, which would greatly
restrict access to care.
4:22:16 PM
MR. SEXTON moved to slide 3, and discussed a partial list of
occupations whose boards grant them the ability, through
statute, to delegate routine tasks. He noted that the field of
ophthalmology was granted the ability to delegate routine tasks,
but somehow optometry was not included in statute regarding
routine medical duties.
[Original punctuation provided.]
Other Healthcare professions in Alaska:
• Professions in Alaska that have solved this problem
with incorporating delegation authority include:
• Medical Doctors, Doctor of Osteopathic Medicine,
Podiatry, Physician Assistants (08.64.106)
• Dental (08.32.346)
• Veterinary (08.98.050 (9,B))
• Pharmacy (08.80.030,(9))
• Chiropractic (08.20.168)
4:22:52 PM
MR. SEXTON moved to slide 4, and discussed the tasks
optometrists routinely delegate, noting that the optometrists do
not delegate the reading and interpretation of test results to
support staff and that HB 309 would not absolve the optometrist
of their responsibilities.
[Original punctuation provided.]
Examples of routine tasks
• Initial patient medical history and reason for visit
• Initial assessment of vision and current
prescription verification
• Blood pressure screenings and automated measurements
of the eye
• Ocular photography and digital imaging for review by
the doctor
• Assisting in medication refills
• Performing peripheral vision testing for
interpretation by the doctor
4:23:24 PM
MR. SEXTON moved to slide 5 and said HB 309 seeks to correct the
omission of delegation authority for optometrists in statutory
language in order to maintain efficiency and effectiveness of
normal optometric office visits.
[Original punctuation provided.]
Current challenges
• In the absence of the ability to delegate tasks,
Optometry will be less efficient and effective at
meeting the demand of patient care that exists in
the state currently.
• Optometry is projected to grow in the future.
• Adding a logistical and financial burden to current
and future Optometrists may contribute to the
shortage of healthcare professionals.
4:23:38 PM
MR. SEXTON moved to slide 6 and discussed the expected impacts
of HB 309.
[Original punctuation provided.]
HB 309 impacts
• This bill will have no impact on billing practices
and will not increase costs to the patient
population.
• The impact of passing this bill will be to ensure
that patients continue to receive appropriate and
effective care supervised by licensed Optometric
Physicians in Alaska.
4:23:57 PM
MR. SEXTON moved to slide 7 and described support for HB 309,
which would allow delegation of routine tasks for optometry as
is statutorily supported for other health professions.
[Original punctuation provided.]
Support
• The Alaska Optometric Association supports this
legislative approach and action.
• HB 309 brings Optometrists in line with other health
related professions in Alaska.
4:24:30 PM
CHAIR BJORKMAN announced invited testimony for HB 309.
4:24:41 PM
BRADLEY CROSS, Chair, State Board of Examiners in Optometry,
Soldotna, Alaska, gave invited testimony in support of HB 309.
He said optometry was responsible for the majority of primary
eye care in the state of Alaska, and optometrists have grown as
a profession to accommodate the needs of Alaskans, urban and
rural. He said remote eye care necessitated skilled
practitioners who have a scope of practice that ensured adequate
care. He stated that the optometric profession, the state board,
the state association, and state legislators, understand and
believe that statement and that Optometry had shown itself to be
economically beneficial to our population, [as well as] safe,
sustainable and directly accountable to the State Board, who, in
turn, is accountable to the legislature.
DR. CROSS said the need for an addition to the State Board [of
Examiners in Optometry] statutes was discovered during a 2023
regulation project relating to telehealth. He acknowledged the
help of Representative Ruffridge and staff to create a simple
and clear solution. HB 309 will spell out that an optometrist
can delegate ancillary testing to an assistant or a technician.
He compared HB 309 with similar legislation for dentistry,
medicine, chiropractic, veterinary medicine and others. He said
it was commonplace in optometry practices across the country to
utilize technicians in the daily patient flow allowing for more
efficient use of resources within the practice thereby improving
access to care. He noted that the population in Alaska was
aging, and the number of providers was decreasing; HB 309 would
allow optometrists to practice at an efficient level. He said
this was more important than ever before; with our older
population, more diseases were present requiring more imaging,
more visual field testing and more frequent visits than a
younger population would demand. He said the inclusion of HB 309
will ensure that optometrists have the backing of state statutes
to provide a high level of care for the patient base that is in
most need of these services. As training and demographics change
over time, optometrists practice more and more medical eye care.
He said to catch up with the change in the dynamic of how
optometry is functioning, it's time to specifically delegate
these tasks to optometric technicians in our statutes. On behalf
of the Board of Examiners in Optometry he thanked the committee
for considering HB 309.
4:27:40 PM
DAMIEN DELZER, O.D., President-Elect, Alaska Optometric
Association, Fairbanks, Alaska, gave invited testimony in
support of HB 309. He said the bill was requested by the board
of examiners and optometry due to a recent research opinion by
the Department of Law. The opinion was that the statute needed
clarification regarding ongoing delegation of routine pretesting
by optometric assistants. He explained that Optometry has
utilized assistants as standard of care and as an industry
standard practice for decades, preceding his graduate
professional education. He said he utilized assistants for the
entirety of his 30 years plus career in Alaska, as well as
previously in the armed forces. He said many states recognized
this long standing industry standard and the use of assistants
is a foregone conclusion in the delivery of eye care, not
requiring any specific statute language. In many states,
including other states where he held licenses, such as North
Dakota and Montana, it was an implied practice, much like we
have done here for many decades in Alaska. He pointed out that
assistants improve access to all types of medical care, as was
earlier presented and specific Alaska statutes addressed this
across nearly all healthcare fields. He said the utilization of
optometric assistants is universal throughout optometric
practices in all states, helping to decrease costs and improve
patient access. He noted optometric assistants will often
perform routine pre-testing tasks under the supervision of a
licensed doctor. These tasks include things such as visual
acuity, like you might have done at the Department of Motor
Vehicles, glasses, measurements, documentation and medical
issues, current and past, as well as medications, allergies,
photography and other non-invasive tests. Assistants receive
nearly all their training on-the-job under the careful
supervision of licensed professionals as well as seasoned and
experienced supervisors, similar to most trades. As the
assistant demonstrates their safety and proficiency, their
responsibilities slowly expand, while always remaining subject
to continuous oversight of the licensed doctor.
4:30:10 PM
DR. DELZER said this thoughtful and simple legislation will
provide the statute clarification as recommended by the
Department of Law to allow the crafting of regulatory language
by the board to carefully regulate this ongoing delegation of
safe, supervised, non-invasive assistance for busy practices,
which in turn continues to improve access for the residents of
Alaska to much needed eye care. Fortunately, the simple
legislation would accomplish this in a manner that is
recommended by Director Robb at no cost to the state, nor cost
to the patients or their insurers. He said the Alaska Optometric
Association and its membership fully support HB 309 and remain
grateful to the sponsor, Representative Ruffridge, and to this
distinguished committee for the opportunity to promptly address
this issue.
4:31:25 PM
ELIZABETH STEVENS, Executive Director, Alaska Optometric
Association, Anchorage, Alaska, gave invited testimony in
support of HB 309. She appreciated the opportunity to testify on
behalf of over 100 optometric physicians who provide the
majority of primary eye care statewide in both rural and urban
communities. The Alaska Optometric Association strongly and
enthusiastically supports HB 309 which would grant the Alaska
Board of Examiners in Optometry the authority to draft
regulations regarding the delegation of routine optometric
services.
4:32:29 PM
CHAIR BJORKMAN held HB 309 in committee.