04/16/2016 03:00 PM Senate FINANCE

SENATE BILL NO. 55                                                                                                            
                                                                                                                                
     "An Act relating to the practice of optometry."                                                                            
                                                                                                                                
3:28:33 PM                                                                                                                    
                                                                                                                                
Vice-Chair  Micciche  MOVED   to  ADOPT  proposed  committee                                                                    
substitute for  SB 55(FIN),  Work Draft  29-LS0524\G (Bruce,                                                                    
4/13/16).                                                                                                                       
                                                                                                                                
Co-Chair MacKinnon OBJECTED for the purpose of discussion.                                                                      
                                                                                                                                
3:28:58 PM                                                                                                                    
                                                                                                                                
ERIN SHINE,  STAFF, SENATOR  ANNA MACKINNON,  explained that                                                                    
the cs incorporated the amendments  adopted by the committee                                                                    
during the April 15, 2016 meeting:                                                                                              
                                                                                                                                
     Page 1, line 12:                                                                                                           
    Delete "by agreement with the State Medical Board,"                                                                     
                                                                                                                                
Co-Chair  MacKinnon REMOVED  her OBJECTION.  There being  NO                                                                    
OBJECTION, it was so ordered.                                                                                                   
                                                                                                                                
3:29:35 PM                                                                                                                    
                                                                                                                                
Vice-Chair Micciche  discussed the  fiscal note  attached to                                                                    
the legislation:                                                                                                                
                                                                                                                                
     CSSB 55(L&C)  expands the  practice of  optometrists to                                                                    
     include  additional  prescriptive authority,  with  the                                                                    
     prescription  of  controlled  substances limited  to  a                                                                    
     seven-day supply. It authorizes  the board to establish                                                                    
     in regulation licensee  continuing education standards,                                                                    
     prescriptive standards,  and the  scope of  practice to                                                                    
     perform ophthalmic surgery and noninvasive procedures.                                                                     
                                                                                                                                
     If the  bill passes the  division will require  $2.5 to                                                                    
     cover legal  costs to amend regulations,  printing, and                                                                    
     postage in the first year.                                                                                                 
                                                                                                                                
     Professional licensing programs  within the Division of                                                                    
     Corporations, Business  and Professional  Licensing are                                                                    
     funded by Receipt Supported  Services, fund source 1156                                                                    
     Rcpt  Svcs (DGF).  Licensing fees  for each  occupation                                                                    
     are  set  per  AS  08.01.065 so  the  total  amount  of                                                                    
     revenue    collected     approximately    equals    the                                                                    
     occupation's actual regulatory costs.                                                                                      
                                                                                                                                
3:30:54 PM                                                                                                                    
                                                                                                                                
SENATOR  CATHY   GIESSEL,  SPONSOR,  stated  that   she  was                                                                    
satisfied with  the committee  substitute. She  relayed that                                                                    
the bill  would update  the statutes governing  the practice                                                                    
of optometry in the state,  and would authorize the board to                                                                    
continue regulating the practice of optometry in the state.                                                                     
                                                                                                                                
3:31:39 PM                                                                                                                    
                                                                                                                                
Co-Chair   Kelly  spoke   to  public   testimony  that   had                                                                    
referenced an optometry school in Washington State.                                                                             
                                                                                                                                
Senator Giessel clarified that an  eye surgeon had testified                                                                    
that he had been denied  acceptance to a school of optometry                                                                    
in Washington  State. She  said that there  is not  now, nor                                                                    
had  there ever  been a  school of  optometry in  Washington                                                                    
State or in Washington D.C.                                                                                                     
                                                                                                                                
Co-Chair  MacKinnon  stated  that  the  public  hearing  had                                                                    
closed on April 14, 2016.                                                                                                       
                                                                                                                                
3:32:34 PM                                                                                                                    
                                                                                                                                
Vice-Chair  Micciche wondered  whether  the  changes in  the                                                                    
current  bill version  allowed for  optometrists to  perform                                                                    
surgery.                                                                                                                        
                                                                                                                                
3:33:56 PM                                                                                                                    
                                                                                                                                
DR.   JEFF   GONNASON,    ALASKA   OPTOMETRY,   KENAI   (via                                                                    
teleconference),  explained that  under  the new  definition                                                                    
optometrists  scope  of  practice would  be  determined  and                                                                    
authorized by  the board.  He said  that the  old definition                                                                    
allowed  for minor  surgeries to  be performed,  but nothing                                                                    
invasive.  He stated  that under  the legislation  the board                                                                    
would  be able  to determine  the scope  of practice,  while                                                                    
still protecting  the public.  He asserted  that legislators                                                                    
were  not  equipped to  make  decisions  on the  details  of                                                                    
medical   procedures,  which   was  why   regulatory  boards                                                                    
existed.                                                                                                                        
                                                                                                                                
3:36:28 PM                                                                                                                    
                                                                                                                                
Vice-Chair Micciche  referred to the limitation  of practice                                                                    
in  the bill,  and wondered  whether it  was similar  to the                                                                    
same provision in dentistry.                                                                                                    
                                                                                                                                
Dr.  Gonnason  agreed with  the  comparison.  He noted  that                                                                    
Section 5 of the bill  stated that no licensee could perform                                                                    
an act beyond their level  of training and qualification. He                                                                    
reiterated that the board existed to protect the public.                                                                        
                                                                                                                                
3:37:27 PM                                                                                                                    
                                                                                                                                
Senator Olson referred to Page 2, line 18 of the bill:                                                                          
                                                                                                                                
     * Sec. 4. AS 08.72.272 is amended by adding new                                                                          
     subsections to read:                                                                                                       
          (e) A licensee may not perform an injection in                                                                        
          the ocular globe of the eye that is a derivative                                                                      
          of clostridium botulinum.                                                                                             
                                                                                                                                
Senator Olson  expressed concern that the  language could be                                                                    
interpreted  to read  that licensees  were  allowed to  give                                                                    
injections  into the  ocular globe  as  long as  it was  not                                                                    
clostridium botulinum.                                                                                                          
                                                                                                                                
Dr.  Gonnason responded  that  no  one injected  clostridium                                                                    
botulinum into the  eye; it simply was not  done. He thought                                                                    
that  the  language  had  been  written  into  the  document                                                                    
because  of  the  fear  that  botox  injections  were  being                                                                    
administered,  which was  not the  case. He  added that  the                                                                    
provision would not  need to be in statute,  the board would                                                                    
put it  in regulation. He  stated that optometrists  did not                                                                    
administer injections  into the  eye. He explained  that due                                                                    
to  increasing  demand,  ophthalmologists  would  eventually                                                                    
need   assistance   for    injecting   drugs   for   macular                                                                    
degeneration, and were currently  training nurses to perform                                                                    
the procedure.                                                                                                                  
                                                                                                                                
3:39:31 PM                                                                                                                    
                                                                                                                                
Senator Olson  wanted assurances  that optometrists  did not                                                                    
inject anything into the globe of the eye.                                                                                      
                                                                                                                                
Dr. Gonnason replied in the affirmative.                                                                                        
                                                                                                                                
3:39:48 PM                                                                                                                    
                                                                                                                                
Vice-Chair  Micciche MOVED  to  report CSSB  55(FIN) out  of                                                                    
Committee   with   individual    recommendations   and   the                                                                    
accompanying fiscal note.                                                                                                       
                                                                                                                                
CSSB 55(FIN) was REPORTED out  of committee with a "do pass"                                                                    
recommendation  and  with  one previously  published  fiscal                                                                    
impact note: FN1 (CED).                                                                                                         
                                                                                                                                
3:40:18 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
3:42:09 PM                                                                                                                    
RECONVENED