Legislature(2023 - 2024)BELTZ 105 (TSBldg)
05/01/2024 01:30 PM Senate LABOR & COMMERCE
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Audio | Topic |
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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.