Legislature(1999 - 2000)
03/31/2000 03:24 PM House L&C
| Audio | Topic |
|---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SB 78-USE OF DRUGS BY OPTOMETRISTS CHAIRMAN ROKEBERG announced the first order of business is SENATE BILL NO. 78, "An Act relating to the use and prescription of pharmaceutical agents in the practice of optometry." Number 0090 SENATOR MACKIE, Alaska State Legislature, testified as the sponsor of SB 78. He explained that SB 78 would authorize optometrists in Alaska to prescribe oral or systemic drugs as is the case in 37 other states. He noted that there was a bill that would have allowed for laser surgery and other types of practices, but that was not included in SB 78 as it includes much controversy and opposition. Therefore, SB 78 allows [qualified] optometrists the ability to prescribe oral medications for problems with the eye rather than necessitating a visit to another physician for this. Senator Mackie specified that SB 78 would not allow an optometrist to do things in which he/she is not trained, qualified and certified to do. He noted his understanding that the groups who have traditionally opposed this in the past, have backed off on this issue. In closing, Senator Mackie said that he would appreciate the committee's support of SB 78. CHAIRMAN ROKEBERG asked if Senator Mackie was aware that the Alaska State Medical Association (ASMA) opposed SB 78. He further asked if ASMA came before the [Senate Labor & Commerce Committee]. SENATOR MACKIE replied no. He remarked, "I'd be surprised actually if they even appeared here." CHAIRMAN ROKEBERG noted that ASMA has representation in the room. SENATOR MACKIE recalled that he had spoken, in regard to the letter, with a representative of ASMA and with Dr. Gonnason. He noted that the vote on the Senate floor was 18-2 and thus he believes there is sufficient support for SB 78. Number 0403 DR. JEFF GONNASON, Licensed Alaskan Optometrist (OD), Alaska Optometry Association, provided the committee with his one page statement. Dr. Gonnason stated, "Optometry is a primary health care profession that examines, diagnoses, and treats disorders of the human eye and we use therapeutic medications, methods and procedures in accordance with professional training and competency." He explained that historically medical doctors have enjoyed unlimited legislative trust in their scope of practice as have other health care professions that are commonly referred to as a limited license such as dentists, podiatrists and nurse practitioners. The scope of practice for dentists, podiatrists and nurse practitioners is determined in regulation by the state boards. Therefore, when something new is invented, their state board can review that invention and does not have to come before the legislature. However, every time something new is invented optometry, it has to come before the legislature for authorization because of the opposition in the past from medical [groups]. Dr. Gonnason pointed out that optometric training began including therapeutic treatment of diseases about 30 years ago. In 1976 North Carolina passed legislation allowing qualified optometrists to prescribe therapeutic medications. Now 37 states allow qualified optometrists to prescribe therapeutic medications, including oral and systemic agents. Therefore, SB 78 would bring Alaska up-to-speed with where North Carolina started. He noted that currently one state, Oklahoma, allows optometrists to use lasers in the treatment of eye diseases. DR. GONNASON pointed out that last session there was a bill that would have allowed optometrists to change such that a optometrist's scope of practice would be determined by the State Board of Examiners, which would be an ideal situation. This would be the same situation that exists for dentists and podiatrists. However, that bill met with opposition. Therefore, SB 78 is a compromise bill that would only allow [optometrists to prescribe] these additional medications. Dr. Gonnason informed the committee that the bill packet should include a letter from the malpractice insurance carriers reporting that there is no difference in premiums or claims between states with or without oral pharmaceutical authority. Furthermore, the Alaska State [Legislative] Budget & Audit Committee performed a study in 1995 in which the committee reported that eye care was improved in Alaska by allowing ODs to prescribe; this also saved money on travel and double visits. This legislation would allow Alaskan optometrists to practice at the currently accepted standard of care and provide access to quality, cost-effective eye care. DR. GONNASON mentioned that last year he wrote a letter to Speaker Porter in which he basically refuted the allegations in the ASMA letter. In conclusion, Dr. Gonnason pointed out that optometrists receive the kind of training necessary to safely prescribe these medications just as do dentists and podiatrists. Number 0760 REPRESENTATIVE MURKOWSKI asked if SB 78 merely allows for oral medication prescriptive authority. DR. GONNASON specified that SB 78 would allow optometrists to prescribe or use any medications at all, by any means, necessary to treat conditions of the eye. He stressed [that these medications could only be used by optometrists] in the treatment of conditions of the eye. He clarified that it would include oral medications as well as suppositories and injectibles. REPRESENTATIVE MURKOWSKI asked if [SB 78] would include intravenous (I.V.) [medications]. DR. GONNASON replied yes, but noted that only very rarely are intravenous drugs required for eye conditions; only one such condition came to mind. REPRESENTATIVE MURKOWSKI surmised, then, that the chart in the bill packet referring to the states that allow oral medication may not necessarily include all the other ways in which a systemic problem can be treated. She expressed concern with the I.V. concept. DR. GONNASON clarified that the list in the bill packet includes states that allow some form of systemic medication. Some of those states, such as Tennessee and North Carolina, allow all forms of systemic medication, which would be the case under SB 78. In some states, the legislation specifies which drugs can be used by an optometrist. Texas just passed legislation that would include oral and injectible medication. Dr. Gonnason remarked, "The main thing for injectibles is essentially allergic reactions where you do the 'epi' gun, adrenaline in the arm for someone that can't breath because they're having an anaphylaxis shock reaction; just not done very often. But we all keep those in our offices, legal or not, because you need to save the person's life, especially out in the Bush." He said that each state is different in regard to the amount of authority of drug use, but almost all states exempt and do not allow schedule I and II drugs as they are not necessary for eye practice. Schedule I and II drugs are not included in SB 78. REPRESENTATIVE HARRIS asked if there are any documented problems in the other states that use this system. DR. GONNASON replied no. He commented that if anything had been before any boards, the committee would have been flooded with it by the opposition. He noted that optometrists have been prescribing therapeutic drugs in Alaska since 1992; although orals were included, [the bill] was limited to topicals at that time. As of last month there have been no complaints to the state board in those eight years. Dr. Gonnason remarked that it is very difficult to convince lay people of an optometrist's education, when very credentialed surgeons are saying otherwise. Number 1058 REPRESENTATIVE HARRIS inquired as to what level of education or competency does one have to show in order to obtain an optometrist license. He assumed that optometrists in Alaska have to have the same level of education as those in other states [that allow this]. DR. GONNASON informed the committee that a doctor of optometry degree is awarded after four years of graduate school; it is a professional program that is identical to dental school. He commented that it is similar to medical school in that everyone uses the medical model and the same textbooks, instructors and lectures are used [as those used by the medical students]. Therefore, it requires eight years of college to obtain an optometry degree as with dentistry and medicine. He noted that most of the opposition is from ophthalmologists, which are specialized physicians who receive extra training in diseases and the surgery of the eye. Ophthalmologists "are definitely the top dog on the food chain in eye care.... We're [Optometrists] not trying to say that we want to do the advanced things the ophthalmologists do, we want to do what we are trained to do." He referred to material in the bill packet which illustrates that the years of education for optometry, dentistry, podiatry and medication are essentially the same. Furthermore, most optometrists now receive a year of residency as well. The graph in the bill packet also illustrates that in regard to the number of hours spent in pharmacology training, the hours were identical in the University of Houston's Optometry College and Baylor College of Medicine. He noted that he has a copy of a college catalog. DR. GONNASON, in response to Representative Harris, said that the training [for optometrists in this area] is there. He pointed out that in Alaska, as is the case in most states, an optometrist must pass the National Board of Examiners in Optometry of which there are three parts. All three parts must be passed in order to apply to Alaska. Within those national boards there is an examination referred to as "treatment and management of ocular disease", which is what is required to prescribe drugs in Alaska. For example, some of the older practitioners without this training would not be allowed to use this; one must have an endorsement to his/her license from the Division of Occupational Licensing. That endorsement is based upon the additional training and the passage of the treatment and management of ocular disease test that is administered by the International Association of Boards of Examiners in Optometry, which is the worldwide standard exam for optometry therapeutic practice. He believed that Catherine Reardon, Division of Occupational Licensing, could attest that the qualifications, certification and the regulation is very stringent. REPRESENTATIVE HARRIS pointed out that the letter in the bill packet from the ASMA says, "Optometrists do not have the education and training that a licensed physician and surgeon have." The letter from the ASMA also says, "We feel that if an individual wishes to practice medicine, he/she should be trained as a physician." He inquired as to Dr. Gonnason's comment on those statements by the ASMA. DR. GONNASON informed the committee that in medical school a physician or a medical doctor receives about one or two days on the eye. Therefore, he was confident that an O.D. graduating from optometry school has far more training in the diagnosis, treatment and management of diseases of the eye than would a M.D. He acknowledged that optometrists [receive less training] than ophthalmologists. Dr. Gonnason related a situation in Nome in which the local O.D. is called in for any eye emergency not the M.D. because [the M.D.] does not know how to handle these cases. If the O.D. has to prescribe a systemic medication, then the physician's assistant has to prescribe the medication. He noted that nurse practitioners can prescribe any medication while their training is at the Master's degree level, which is slightly below the Doctorate level of optometry. He returned to the dentist example and asked, "If the M.D.s wrote you a letter and said, 'We don't think dentists should be prescribing pain medication or antibiotic pills because they're not physicians.' What would you say? You would say, 'Well, they're dentists.'" Optometrists receive the same training [in pharmacology] as dentists. Number 1400 REPRESENTATIVE HALCRO pointed out that the ASMA is further concerned that optometrists would be prescribing therapeutics, "which often have an impact not only on eye [issues] by interact with many body systems." In regard to the chart comparing the education, it illustrates that the general practitioner [in comparison to an optometrist] has almost twice as many hours required in human anatomy, physiology and neurophysiology. He asked if this is an area of concern due to an optometrist receiving far less instruction in this area. DR. GONNASON remarked that it [the education for general practitioners and optometrists] is of equal construction. He noted that the chart in the packet is from 1987. Dr. Gonnason explained that part of the training in pharmacology is the interaction of different drugs, which results in a detailed history of a patient. Part of the training deals with the interaction of drugs as systemic drugs do affect the entire body. Dr. Gonnason informed the committee that optometrists are not trained in the prescribing of cardiac medications. Optometrists would only prescribe related to the eye. However, he noted that although he is familiar with cardiac drugs, he is not familiar with the extra hours of detail. Similarly, the dentist is not trained in that area either, although a dentist is trained in the emergency treatment of interactions and allergies with the drugs. REPRESENTATIVE HALCRO asked whether the difference in the training in physiology and the neurophysiology is the basis for the ASMA's contention that optometrists may be prescribing drugs for which there are other complications that the optometrist would not be aware of. DR. GONNASON stated that [ASMA] is not aware of the training of optometrists. He provided a copy of a more current four year optometric degree program. Basically, in the third and fourth year of the optometrist degree program there is a lot of clinic involved just as in medicine. Number 1641 CHAIRMAN ROKEBERG asked if the licensure regulations in Alaska require that optometrists have any mandatory errors and omissions (E&O) insurance. DR. GONNASON answered that optometrists all have malpractice insurance, although he did not believe it is required by statute. He informed the committee that an optometrist's malpractice insurance costs about $400 per year. Dr. Gonnason pointed out that the [Maginnis & Associates Correspondence] says that the claims rates and the insurance premiums are basically the same regardless of whether the state allows optometrists to prescribe systemic and oral drugs or not. He also pointed out that California passed legislation allowing optometrists to prescribe all topical and some systemic medications. During that process in California, the California Optometry and Ophthalmology Association agreed to commission an independent evaluation assessing the competency and cost effectiveness of optometrists treating diseases. He had the highlights from that independent evaluation which was performed by Price Waterhouse Coopers in 1999. Dr. Gonnason read the conclusion of that independent evaluation as follows: Optometrists practice therapeutics with at least the same level of competence as ophthalmologists and primary care providers managing the same problems. This conclusion is based on the study result. Optometric charts show no significant difference from ophthalmology charts in compliance with the eye care standards and optometrists were significantly better compliance than the charts of general physicians and mid-level practitioners. DR. GONNASON clarified that he is not knocking general M.D.s, but in general people go to a general M.D. who prescribes an eye drop that does not work. In such a case, the person ends up in an optometrist's office where the drop that does work is administered. He said, "It's not that the M.D. didn't know, but he's not as focused in on the details of eye disease as we are." DR. GONNASON pointed out that this independent study found, in regard to cost effectiveness, "The magnitude of savings is substantial and optometrists provide a significant economic benefit to their patients." He directed the committee's attention to the chart that details the average cost to a patient with pink eye. A person with pink eye who sees a general physician, an ophthalmologist and optometrist faces an average charge of $76, $83 and $41 respectively. Although ophthalmologists are necessary, one does not need to fly from Nome to Anchorage in order to receive treatment for pink eye from an ophthalmologist. He noted that optometrists could not [even] treat pink eye until a few years ago. CHAIRMAN ROKEBERG noted that the bill packet includes a letter from Dr. Hart Hodges, Ph.D. from Northern Economics, who disputed the notion that there is no cost difference in the eye exam conducted by an ophthalmologist and an optometrist. Chairman Rokeberg found that interesting as his own personal experience seemed to illustrate that an eye exam from an ophthalmologist cost more than one performed by an optometrist. Chairman Rokeberg commented that he was surprised that, given the rural nature of the state, [the rural areas] have not been present requesting this earlier. DR. GONNASON said, "Well, they have." He explained that most of it has been done under the auspices of public health. Optometrists in the Bush have been prescribing drugs for 30 years under federal authority. However, now Native corporations are hiring private optometrists and their hands are tied. He noted that he had requested that Dr. Ford, an Ophthalmologist and Surgeon from Pacific Cataract and Laser, testify on this legislation. Dr. Ford is one of the world's highly respected eye surgeons. Number 1901 CHAIRMAN ROKEBERG pointed out that according to Dr. Hodges, Dr. Ford contracts with optometrists for follow-up care for his laser surgery patients in the Anchorage area. Chairman Rokeberg asked if that is true. DR. GONNASON specified that Dr. Ford co-manages [with optometrists for follow-up care]. He said, "All of them do." He explained that if he has a patient that wants laser surgery, he examines the patient and does all the mathematical numbers for the patient's surgery. The patient is then sent, with the numbers, to one of the ophthalmologists in Anchorage. Dr. Gonnason indicated that the ophthalmologists really do not have a problem with optometrists using drugs, but rather are concerned with optometrists moving into the laser end where the money is made. After the surgery, the patient would return to the optometrist who would perform follow-up care. The optometrist charges a fee for his part and the surgeon charges a fee for his part and those fees are totally independent. DR. GONNASON answered, in response to Chairman Rokeberg, that anaphylaxis is a technical term. He explained that optometrists can only prescribe in treatments of the eye; however, this would allow the treatment of a person in an emergency allergic shock situation. He commented that it is very rare and that he has never seen such a case in his 24 years of practice, although he noted that he is trained to take care of such a situation. Dr. Gonnason emphasized that anything that is done would only be done in the standard of care and anything performed outside of that would be a violation of the law. CHAIRMAN ROKEBERG recognized that optometrists, under SB 78, would be excluded from the use of schedule IA and IIA drugs. He inquired as to what other schedules of prescriptive pharmaceuticals an optometrist would give. He further inquired as to the percentage of those that would be administered intravenously. DR. GONNASON estimated that if he were to write 500 systemic prescriptions, probably only one or two would possibly be injectible or administered intravenously. Very few of the prescriptions optometrists would write in the treatment of the eye would involve an I.V. In regard to oral prescriptions, he informed the committee that the main ones would be medication in the treatment of glaucoma, antibiotics for infection and then pain. The schedule IA and IIA drugs are excluded as they are the most dangerous levels of drugs, and furthermore there is almost no incidence in which an optometrist would need those. Therefore, that restriction does not really need to included, but it illustrates that optometrists are not interested in expanding beyond what is necessary. Number 2131 REPRESENTATIVE MURKOWSKI referred to the map in the bill packet which specifies the states that allow the use of oral pharmaceutical agents by optometrists in the treatment of eye disease. She asked if SB 78 is more expansive than what the other states allow with the use of oral medication [by optometrists]. DR. GONNASON answered that SB 78 is more expansive than some [states] and less expansive than others. Of the 37 states that allow the use of oral pharmaceutical agents by optometrists, he estimated that about five states allow a little more than SB 78 as those states do not restrict the schedule IIA drugs. He estimated that SB 78 is similarly aligned with about half of the states, with the remaining states having a more restricted authority. Of those states with the more restricted authority, Dr. Gonnason said that those states passed those laws early on and are now seeking amplification of those laws. Dr. Gonnason estimated that "we" [Alaska, with SB 78,] would be in the top third of those states in regard to prescriptive authority. REPRESENTATIVE MURKOWSKI asked if the treatment of anaphylaxis treatment would always be an emergency response situation. DR. GONNASON replied yes. He explained that anaphylaxis is a Type I allergic reaction and, systemically, it is an emergency. However, a person can receive a anaphylactic reaction locally such as when a person receives a mosquito bite to the eyelid, which instantly puffs up. Such anaphylaxis is not treated with the "epi gun." He noted that this language is similar to that in almost all other states. Number 2248 SENATOR MACKIE requested that Dr. Gonnason speak to the concern regarding how pharmacists would know who is qualified to issue prescriptions and who is not. Senator Mackie understood that there are 80 optometrist in Alaska, of which about 75 are qualified to issue prescriptions. He further understood that the state would have to issue an endorsement/certification in order to do this. He requested that Dr. Gonnason describe how this would all work. DR. GONNASON explained that basically, the state gives optometrists their licenses which note a pharmaceutical agent and prescription use endorsement. Once this law first went into effect, he had to go to all the pharmacists he knew and provide them with a copy of his license. Furthermore, the Division of Occupational Licensing has a copy of all those [optometrists] that are certified. Basically, the optometrist would make that information available to the pharmacist. In regard to the endorsement, Dr. Gonnason stressed that this [SB 78] does not grandfather in anyone. REPRESENTATIVE MURKOWSKI asked if there is any ongoing [education]. DR. GONNASON interjected, "Yes, 18 hours per year." If the optometrist does not have the drug authority, then he/she would only need 12 hours [of continuing education]. In further response to Representative Murkowski, he pointed out that the board requires an extra six hours of education in disease management and pharmacology. With the passage of SB 78, the board may or may not require additional requirements. REPRESENTATIVE MURKOWSKI said that she would like to think that there would be a different set of standards on top of those [already in place]. DR. GONNASON informed the committee that almost all of the optometrists in the state took a 100-hour drug training course in 1982. This training course covered the treatment of diseases because it was thought that optometrists would have drug authority in 1982. However, it took 10 years before such passed in 1992. He emphasized that everyone was required to take that [drug training course] again, which had been updated and included the training for systemic drugs. Therefore, everyone who currently has a pharmaceutical agent and prescription use endorsement has the systemic training, although that portion of the 1992 legislation was given up in a compromise. This bill, SB 78, would simply restore that which was compromised eight years ago. He acknowledged that the board could require, through regulation, that optometrists need to receive further training. Dr. Gonnason said, "I can assure you that none of my colleagues would not be prescribing anything that they weren't completely comfortable with. Why would they? There's no financial remuneration in it and we're very conservative." He pointed out that optometrists are primary care practitioners that handle routine cases. He informed the committee that he is in a building with family doctors, who send him all the eye cases. However, if it is a case in which he is uncomfortable, he refers the patient to a ophthalmologist; that is how the system works. He attributed that system to be the impetus for the better relationship that the optometrists and ophthalmologists have in Anchorage. Therefore, he did not believe that ophthalmologists have any serious opposition to SB 78. TAPE 00-40, SIDE B CHAIRMAN ROKEBERG referred to Mr. Hodges letter, which says that ophthalmologists "are under some pressure to remain quiet. If any single ophthalmologist speaks out against the bill, then that person runs the risk of loosing referral business from optometrists ...." Chairman Rokeberg turned to Dr. Ford's testimony. Number 0025 DR. ROBERT FORD, Ophthalmologist, testified via teleconference from Las Vegas. He informed the committee that he has had a practice in Anchorage for about the last three years. He also informed the committee that he is the owner and founder of Pacific Cataract and Laser Institute, which employees six other ophthalmologists and about 15 optometrists. As mentioned earlier, he noted that he has worked closely with optometry in co-management for the last 15 years. Dr. Ford completely agreed with everything Dr. Gonnason said. DR. FORD stated that he believes that the State of Alaska needs this bill to be passed. There are so many patients who could have an episode of acute glaucoma or something requiring a systemic medication. It is simply not practical for [some of] these people to see an ophthalmologist soon enough to handle it. He pointed out that it does not help to see a general M.D. as a general M.D. would not have the knowledge, although he/she would have the prescriptive authority. Dr. Ford said that he knew this to be the case as his father was an excellent family doctor, but not an eye doctor and thus did not understand the eye as well as optometrists do. DR. FORD turned to the issue of whether this would be safe and whether there is adequate training. He pointed out that as an ophthalmologist, he is legally qualified to prescribe any kind of medication, including cancer chemotherapy. However, he said that he does not prescribe such [medications] because he does not understand them. Dr. Ford said, "Basically, it becomes a matter of my integrity to only prescribe things I understand." He noted that most of the drugs he prescribes now are new drugs, new since his training. Therefore, any drug he chooses to use he must read up on it and obtain education on the drug before using it. Basically, that is the same system that the optometrists will use. Even if SB 78 passes, optometrists will have the legal ability to prescribe medication they do not understand and thus everyone will have to depend on their professional integrity as is the case with all other professionals. CHAIRMAN ROKEBERG asked if Dr. Ford agreed with the ASMA's statement that this is not a turf issue, but rather a quality of care issue. DR. FORD specified that it is not that simple. There are important questions in regard to safety, which is a quality of care issue. However, most of the strong feelings that exist are based on turf issues. Number 0173 CATHERINE REARDON, Director, Division of Occupational Licensing, Department of Community & Economic Development, specified that her division staffs both the [State] Medical Board and the Board of Optometry. The Optometry Board is on the record as strongly supporting SB 78 and the Medical Board has not taken a position on this issue. CHAIRMAN ROKEBERG requested that Ms. Reardon explain the requirements and regulations for optometrists in regard to their continuing education and anything that relates to medications or drug dispensing. MS. REARDON explained that AS 08.72.175 allows the board to issue endorsements authorizing a license holder, an optometrist, to prescribe and use the pharmaceutical agents described in the statute being amended [under SB 78]. Therefore, the board has that authority and has adopted regulations doing that. When the board adopted regulations, the board decided to do two different sets. One set of regulations is geared towards optomotrists who can use the topical drugs and the other set of regulations is geared towards optomotrists who can prescribe and use. She believes that two track system was established because perhaps, there were some optometrists whose training was not as recent or as comprehensive. Ms. Reardon pointed out that the regulation 12 AAC 48.025 for the prescription and use endorsement says, "An applicant for that endorsement must submit documentation of an average of 12 contact hours of approved continuing education in ocular pharmacology or pathology for each complete calendar year since the date of the exam that they had to pass initially on treatment and management of ocular disease." She noted that this would be the case unless the exam was passed within two years of the application for the endorsement. She noted that the regular optometry license [requires] some continuing education. Number 0305 REPRESENTATIVE HALCRO related his understanding, from Ms. Reardon, that optometrists are not currently required to have E&O insurance. MS. REARDON stated that almost none of the professions licensed through the division are required to have malpractice liability insurance. REPRESENTATIVE HALCRO said, then, there is not a difference between levels of the profession in which one level would be required to have malpractice insurance and the other does not. MS. REARDON replied no. REPRESENTATIVE MURKOWSKI turned to the issue of notifying people, pharmacists, whether one is on the prescribe and use list. She inquired as to how problematic this could be. For example, what if a pharmacy receives a call, on a Saturday night, from an optometrist prescribing a medication that would be allowed under SB 78. If the division's offices are not open for confirmation, would the pharmacy fill the prescription even if there is nothing on record saying that the optometrist could prescribe the medication. Or would the pharmacy err on the side of caution? MS. REARDON pointed out that pharmacists do bear some professional responsibility for making those decisions and thus some may always decide to err on the side of caution. She noted that Alaska receives many visiting doctors, and therefore there are potentially a lot of new faces that a pharmacists would see. Currently, the pharmacist may be requesting a copy of the optometrist's license, which shows the endorsement. Perhaps, some pharmacists will refuse to allow the prescription until [he/she can verify the endorsement of the optometrist when] the division office opens. Ms. Reardon informed the committee that [the division] has an Internet site where people can look up who is licensed, which she indicated would ultimately reach the point where people would probably feel comfortable using the site. She suspected that many late night pharmacy calls would be an emergency situation. CHAIRMAN ROKEBERG asked if anyone else wished to testify on SB 78. There being no one, Chairman Rokeberg closed the public testimony on SB 78. He then inquired as to the will of the committee. Number 0491 REPRESENTATIVE MURKOWSKI recalled Dr. Gonnason's comments that the ophthalmologists are okay with SB 78. However, upon the advice of Dr. Hodges, she called two ophthalmologists both of which were opposed to it [SB 78]. Therefore, she commented that she did not believe the turf wars are over. She acknowledged the concern in Alaska that there are many areas where there is not an ophthalmologist. REPRESENTATIVE HALCRO recalled that last year there was a similar situation with the psychologists and the psychiatrists. He asked if that bill is still in the committee. CHAIRMAN ROKEBERG indicated that to be true. REPRESENTATIVE HARRIS spoke in favor of SB 78 as 37 other states are doing similar things without serious problems. Number 0610 REPRESENTATIVE HARRIS moved to report SB 78 out of committee with individual recommendations and the accompanying zero fiscal note. There being no objection, it was so ordered and SB 78 was reported from the House Labor & Commerce Standing Committee. The committee took a brief at-ease from 4:27 p.m. to 4:32 p.m.
| Document Name | Date/Time | Subjects |
|---|