HOUSE BILL NO. 103 "An Act relating to the practice of optometry." 3:27:21 PM REPRESENTATIVE IVY SPOHNHOLZ, SPONSOR, read a prepared statement: HB 103 gives authority to the Board of Optometry to regulate the practice of optometrists, much as is done by doctors, nurses, midwives, chiropractors and dentists. It ensures that the Board of Optometry will have the opportunity to update their current and continuing standards and scope of practice based on the best evidence available. The bill will not allow optometrists to provide services outside of their scope of practice like performing invasive surgeries which will continue to be illegal. What it will allow is for optometrists to utilize the State of Alaska's rigorous regulatory process to manage themselves just as doctors, nurses, midwives, chiropractors and dentists do. HB 103 allows our robust regulatory process to work. The process for developing new regulations is public and transparent, ensuring that any new regulations will be fully vetted by the board, the public and the Department of Law before it becomes regulation. The Board of Optometry has a strong track record of regulating itself. In fact, the Board has implemented higher continuing education standards on the profession than the Legislature has required in statute which makes a strong case for why this board is more than capable of regulating its own education and practice. (Statute: 15 hours of continuing education while optometrists have required themselves to have 36 hours of continuing education.) It is my hope that this bill will get the Legislature out of the business of managing optometrists, so we can focus on our efforts and energy on issues which do require our attention and optometrists can get on with the business of caring for Alaskan's eye health. Co-Chair Foster invited Dr. Barney to the table. He reviewed a list of other available testifiers. DR. PAUL BARNEY, DOCTOR OF OPTOMETRY, introduced himself. Representative Wilson had been asked for a definition of surgery. She wondered if the doctor would have any issues if a definition was added to the bill for further clarification. Representative Spohnholz responded that she had strongly resisted adding a definition of surgery to the bill. She was intentionally trying to move the discussion out of the legislature's hands. She asserted that adding a definition of surgery would keep the discussion in the hands of the legislature. An invasive surgery was already not allowed in statute. It was unclear what the scope of practice would be for optometrists in 20 years, 30 years, or 40 years. She provided an analogous situation. She suggested that when a person went to the dentist 20 years previously the things a hygienist did versus what a dentist did were very different from what they did presently. For instance, currently, she visited the dentist's office twice per year. She saw the dentist at one visit and the hygienist at both. A hygienist provided almost all her oral health needs with very little consultation from her dentist, which 20 years ago would not have been imaginable. She did not think the legislature needed to be a part of such a conversation. She believed that the conversation should be had between the health care professionals and providers who were keeping on pace with the standards of practice and educational standards. She made the case that the definition did not belong in the bill. 3:32:25 PM Representative Wilson asked for the reference to the definition of invasive surgery in statute. Representative Spohnholz read the statute: AS 08.72.273 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. Representative Kawasaki referred to Section 3. He asked about the removal of language regarding the applicant and continuing education including eight hours for pharmaceuticals and 7 hours for non-topical therapeutic pharmaceutical agents. The language would be replaced with language that required continuing education requirements as prescribed by the board. He asked her to clarify whether the goal was to reduce the number of hours or to allow the board to determine the requirements. Dr. Barney replied that 8 hours of pharmaceutical requirements were written into statute a couple of decades prior. At the time the law was written, most of the education did not deal with pharmaceuticals. The legislature wanted to make certain that pharmaceutical education was required. Currently, the education available had changed dramatically. Most encompassed pharmaceuticals and their applications. He stated that the board was more likely to increase the number of required hours of education rather than reduce them. Representative Kawasaki mentioned concerns about the board overseeing the establishment of regulations for licensed optometrists, as they could permit them to do things outside of their scope of practice. He asked Dr. Barney to address the issue. Representative Spohnholz relayed that the primary concern of the opposition to the bill was that the board would start authorizing practices well outside of practitioners' education and expertise. There were similar professional distinctions such as those between dentists and oral surgeons. Dentists did not perform oral surgery, and there was no major concern or outcry that they were expanding their authority to do so. It was not within the scope of their training and practice. She highlighted that there was a rigorous process for drafting new regulations; they were required to be drafted in partnership with the Department of Law. The goal of the process was to to reconcile any proposed regulations with existing statute. The regulations were also thoroughly vetted and included public input. She was confident that the Ophthalmologists would be happy to participate in the same process. The Department of Law would go through a more rigorous review of the process following public comment. She was confident that the Department of Law and the attorney general would not allow for an expansion of the scope of practice beyond that which optometrists were trained and had the necessary expertise. 3:36:52 PM Representative Kawasaki asked how a licensed optometrist was regulated versus a hygienist. He wondered how optometrists were qualified. Representative Spohnholz deferred to Dr. Barney. Dr. Barney responded that to be eligible for licensure, an optometrist or student of optometry had to take a board examination. The board process started when optometry students were in school. A person had to take national boards and pass all sections to be eligible to take the state license test. For someone who graduated in 1980, for example, the statutes had not changed significantly. There had been a couple of scope-related bills that passed. Each time there was a scope expansion in which continuing education was required everyone had to get the training. The credits were offered in accredited colleges of optometry and had to be taken and successfully completed before optometrists could conduct the expanded procedures. The board would do something similar if HB 166 passed. Representative Kawasaki spoke to the comment about a person being licensed in 1970 versus presently. He mentioned driver's licenses. His mom got her license in 1950 and did not have to requalify for a license or take another test. He wanted to ensure strict confines of performance. Dr. Barney conveyed that continuing education was required on a yearly basis. If anyone were to fall behind on that requirement their license would be in jeopardy. Representative Spohnholz added that in contrast with Representative Kawasaki's mother's driver's license, which she believed required a periodic update to maintain it, an optometrist or another healthcare professional was required to do continuing education to demonstrate that they were keeping pace with the changing profession over time. 3:40:11 PM Representative Wilson thought that the statute AS.08.72.273 did not define invasive surgery, rather, it discussed foreign bodies. She was looking for the definition of invasive surgery. Representative Spohnholz understood there to be a definition. She had talked with the Department of Law recently looking for the definition of invasive surgery. The department indicated it would get the definition of invasive surgery from the medical board. If the medical board's standard was used, the invasive surgery standard would be the same for dentistry, optometry, podiatry, across professions for anyone wanting to use a laser or knife to cut someone open. Representative Wilson wanted to hear from the Department of Law. JOAN WILSON, ASSISTANT ATTORNEY GENERAL, DEPARTMENT OF LAW, saw no definition for invasive surgery in statute. She furthered the board would likely proceed to define standards and practices, including eye surgery, in regulations. A three-fold review process: the board would draft regulations and a public notice stating that the board was considering new regulations. The Department of Law would then review the public notice to ensure the adopting agency was identified, the statutory authority and the statutes being implemented were identified, and deadlines were set for comments. The department also made sure that if an oral hearing was held, it was laid out properly. The point was for due process and public input. Co-Chair Seaton asked Representative Wilson to repeat her questions. Representative Wilson wanted to know where the definition could be found in statute. Representative Spohnholz relayed that the definition was not in statute but it was in regulations. She relayed that she had been working on the bill with Harriette Milks, Assistant Attorney General. Joan Wilson was pinch hitting while Ms. Milks was unavailable. Ms. Wilson would look up the medical regulation. Co-Chair Seaton indicated there would be time to find the definition, as there would be additional hearings on the bill. 3:45:21 PM Vice-Chair Gara liked the provision of the law that stated that an optometrist could remove a foreign object from someone's eye in case of an emergency. He asked what was in Alaska law that prevented someone from doing Lasik surgery compared to the laws of other states where optometrists were able to conduct the procedure. Mr. Barney replied that optometrists did not perform Lasik surgery in other states. Co-Chair Seaton asked if Dr. Barney had a statement he wanted to put on the record. Mr. Barney read a prepared statement: My name is Dr. Paul Barney, I am an optometrist and the current chair of the Alaska Board of Examiners in Optometry. I am also a past president of the Alaska Optometric Association. I live and practice in Anchorage and have done so for the past 17 years. I'm here today in support of HB-103. I support HB-103 because it will allow the Board of Optometry to regulate the details of the practice of Optometry, which is how Advanced Practice Nurses, Dentists, and Medical Doctors are regulated in Alaska. This legislation will not set a new precedence in health ca re, nor will it be a risk to Alaskans since this is already the way other health care providers are successfully regulated in Alaska. HB-103 will give Optometrists better opportunity to practice to the highest level of their education by allowing the Board of 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. You'll hear arguments against this legislation stating that it will be dangerous to allow Optometrists to regulate themselves. But like all other professional regulatory boards, the Board of Optometry cannot promulgate regulations for practices or procedures that are beyond the education of Optometrists. The Board of Optometry is overseen by the AK Department of Law, just like other health care boards, and the AK Department of Law would ensure that the Board of 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 of their scope of education. As a result, there is 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 who do provide care outside of their education. As chair of the Alaska Board of Optometry, I can assure you that the primary concern of the Board is the safety of the public. In the six years that I have served on the Board we have had no complaints from the public that were serious enough to even consider disciplinary action. Optometrists are conservative and cautious practitioners and the passage of HB-103 would not change their conservative nature. I would also like to share with you how I practice. I'm the Center Director of Pacific Cataract and Laser Institute in Anchorage. Our practice is a referral only practice and we specialize• in cataract care, laser vision correction, and medical consultative services. I work with an ophthalmologist and a nurse anesthetist. We all practice to the highest level that statutes will allow and by doing so, as a team we ca n provide high quality, more affordable care to Alaska ns. I have a very good relationship with the ophthalmologist that I work with, but if I were to provide ca re that is outside of my education it would not only jeopardize my relationship with the ophthalmologist but it would also undermine a n already very successful practice. Optometry provides over 70% of the eye care in the U.S. In some rural areas of Alaska, Optometrists are the only eye care provider in the community. 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 Alaska Board of Optometry. These changes are important to allow the profession and practice of Optometry to incorporate new technologies and advances in eye care as they occur. The citizens of Alaska deserve to be served by a profession that is allowed to stay current with advances in education and new technologies in eye care. I respectfully urge you to support HB-103. 3:50:52 PM DAVID ZUMBRO, SELF, ANCHORAGE (via teleconference), was an eye physician and surgeon in Anchorage and was a partner with Alaska Retina Consultants. He strongly opposed the legislation. He indicated that the legislation was not a simple house cleaning bill. Rather, it radically redefined a profession. Although the bill seemed innocent and safe and, as written, would allow non-physicians and non- surgeons to determine what medical and surgical treatments could be done to an eye. He believed it was special interest legislation. It was not safe for patients. He wondered where the public outcry was for the legislation. He asked for proof that current practice regulations adversely affected Alaska patients and the Alaska optometrists. It had been stated that the bill was not about surgery and that no surgeries would be done for which optometrists were not trained. He was worried about surgery. He relayed that a local optometrist told him that when the bill was first crafted that optometrists wanted to perform intraocular injections of medications currently performed by retina physicians. The current bill removed all previous regulations preventing injections. He wondered why regulations would be removed that prevented injections. He suggested that there were many bills in many states that would allow optometrists to advance their scope of practice into lasers and surgery. As a result, several states had adopted definition of surgery language in their statutes. Alaska could do the same thing. He opined that the bill was about advancing the optometric scope of practice into the practice of medicine for which they did not have training. He used to teach ophthalmology residents when he was active duty in the US military. One of the most difficult things to impart to young physicians in training was when to take a step back and not do something. He spoke of the Hippocratic Oath which all medical physicians took requiring them to do no harm. The surgical maturity to sit back and observe a patient did not happen overnight. It took many months of direct supervision and guidance by qualified and experienced physicians. The field of optometry did not have such a type of training background when it came to procedures and lasers. They were not trained in any ophthalmic procedures, lasers, or surgeries. He had no problem with the Board of Optometry regulating the Optometry profession in the practice of optometry. However, if the bill became law optometrists would be regulating themselves in the practice of ophthalmology. As an ophthalmologist he felt he had a say in the issue. The regulation would be without any physician or surgeon oversight, without any training or experience or background, and he had concerns about patient safety and its dangers. He thanked the committee. Co-Chair Seaton asked how many ophthalmologists were in Alaska. Dr. Zumbro responded that there were approximately 26. Vice-Chair Gara agreed with not wanting optometrists to perform surgery. The doctor prior had indicated there was no intention of optometrists doing surgery. He asked Dr. Zumbo if he agreed that in other states optometrists did not perform Lasik surgery. Dr. Zumbro agreed that optometrists did not do Lasik surgery in the United States. 3:55:32 PM DR. JANEY CARL ROSEN, SELF, ANCHORAGE (via teleconference), was a Doctor of Ophthalmology, specifically an oculoplastics surgeon and neuro-ophthalmologist which meant he was an eyelid surgeon and worked with neurology and neuro surgery. He took care of bumps and cysts on eyelids. He provided more information on his professional background. He had heard repeatedly the bill was not about surgery, optometry had no business doing surgery, and optometrists did not want to do surgery. The sponsor had said the bill was not about surgery and her aide had stated that all surgery language was removed from the bill. He had heard that as time changed the scope of practice should be modernized by the optometry board and should a surgical procedure be deemed within the scope of practice by the board they did not want to come back to the legislature. The assistant attorney general previously stated that public testimony would help decide if a surgery was appropriate for an optometrist. He wondered if members were bothered by those statements. He suggested that not only would no one have actual surgical experience on the board and the legislature would ask the public for help. He thought asking an expert with actual experience was more appropriate. He reviewed several examples of problems from botched surgeries. Dental boards and nurse practitioner boards policed themselves because they learned procedures in graduate school. Optometry students did not perform surgery, lasers, or injections on real people. He did not believe an 8-hour class was enough training. He was asking folks to wake up and consider what was being proposed. He read from the Journal of the American Medical Association about a study done in Oklahoma where they performed laser surgeries. He believed the legislation was racing towards a slippery slope. He thought there should be more public outcry. 3:59:06 PM DR. KELLY LORENZ, SELF, ANCHORAGE (via teleconference), was a board-certified Ophthalmologist and strongly opposed HB 103. She believed the bill was an unprecedented expansion of practice. The legislation would allow for limitless surgical procedures without any defined training in surgical techniques. She indicated that she had met patients that had been told by their optometrist that there was only one cataract surgeon that came to Alaska. The bill did not have the best interest of Alaskans in mind and there was no public outcry for it. She spoke of the importance of having a skilled professional with years of training under the supervision of an experienced preceptor. She read statistics from a medical journal about a recent study regarding laser procedures in Oklahoma and the fact that optometrists had repeated the laser more than twice as much as ophthalmologists. She thought it was also essential to have the ability to manage the inevitable complications that arose from laser and traditional surgery. She brought up other serious issues members should consider before signing what she considered to be a blank slate. She advised members to be cautious and to demand specifics. She urged members to oppose the bill in its current form. 4:01:41 PM DR. ANDREW PETER, SELF, HOMER (via teleconference), was an optometrist from Homer and asked members to support HB 103. He relayed a list of services he provided. He mentioned that the clinic's daily schedule could accommodate 4 to 6 urgent care patients. It was common for the appointments to be fully utilized. He spoke to the challenges of living in rural Alaska. He quoted some statistics concerning the number of optometrists and ophthalmologists in the state. He encouraged members to help optometrists be more nimble and accessible. He thanked the committee and made himself available for questions. Representative Wilson thought the definition of surgery was the key issue. She wondered if it would be something that could be discussed. Dr. Peter responded that one of the ophthalmologists had defined surgery as cutting, blading, or altering tissue. Under that definition, tattoo artists and tattoo removal specialists performed surgery. He relayed that if a patient came in with a piece of metal in their eye and he removed it, it would be considered surgery. He provided other examples of potential surgeries. He hoped the legislature could take itself out of the business of managing optometry eyecare. 4:06:16 PM DR. JILL MATHESON, SELF, JUNEAU (via teleconference), was an optometrist in Juneau. She spoke of her previous experience on the Board of Optometry. Over the previous 25 years she had testified numerous times before several legislative committees in support of changes to the Alaska optometry statute. Efforts had been successful due to the level of trust legislators had given optometrists over time and after sifting through testimony. She asked for member's support in having the optometry board regulate optometrists. The bill did not give any expansion of privilege to optometrists. It allowed the optometry board to decide what optometrists were trained and qualified to do via the regulatory process of the board and within their scope and training. She assumed that the members of the state board were appointed and confirmed by the legislature to do the same. There were separate boards because each profession was unique. She suggested that only optometrists knew what doctors of optometry were trained and qualified to do. She was aware members were trying to figure out what "fiscally responsible" looked like. The bill had been heard by four committees multiple times. She suggested that if the optometry board could regulate optometrists there would still be a very public process via open public testimony. Also, boards had to be self-sufficient. The bill allowed the profession of optometry to evolve. She trusted the appointed optometry board members to make any necessary changes. 4:09:15 PM DR. KURT HEITMAN, AMERICAN ACADEMY OF OPHTHALMOLOGY, SOUTH CAROLINA (via teleconference), strongly opposed HB 103. He remarked that the bill was a surgery bill. The bill made two crucial changes to existing Alaska law. First, it removed surgery restrictions already in existing law. It also inserted a new definition of the word optometry in Section 6 that included the words "treatment" and "procedures". The insertion of the word treatment put no limitations on the type of treatment. In other words, all surgeries in the eye would be allowed under the law because the Board of Optometry could define invasive surgery any way they wanted. HB 103 allowed the board cart blanch authority to redefine their field into a surgical field. He had seen an example in North Carolina where optometrists defined laser as non-invasive. He wondered why proponents of the bill opposed the inclusion of language that clearly specified that surgery was outside the scope of practice of optometrists avoiding patient harm. Without specific language restricting surgery, Alaska would be the first state in the country to adopt such broad, unprecedented legislation. There would be no restrictions of optometrists being able to obtain surgical privilege. Optometrists provided a valuable service to communities and were an integral part of the eyecare team. However, they were not medical doctors and did not graduate from a comprehensive surgical residency. There were only three states that allowed optometrists restricted surgical authority. The first was Oklahoma. In Oklahoma, optometrists expanded scope to include surgeries because of language in a bill similar to HB 103. He continued to provide background regarding Oklahoma law. He had reminded the board of an incident at the Palo Alto VA hospital where veterans were hardened because of poor glaucoma follow-up. Because of the incident the VA strengthened its directives prohibiting optometrists from performing laser procedures - the same procedures that would be allowed by the current language in HB 103. He disagreed that the bill was similar to other bills governing professional boards such as nursing, dentistry, or engineers. Unlike nursing and dentistry, optometry school was not a medical or surgical education. Optometrists received about 1900 hours of clinical education in their 4-year training compared to 20,000 hours that ophthalmologists received, about one-tenth the medical education. He disagreed that the bill was about governing boards. He continued to provide a comparison between education received by optometrists and ophthalmologists. He thanked committee members. 4:13:47 PM DAVID KARPIK, SELF, KENAI (via teleconference), was a Doctor of Optometry. He spoke in support of HB 103. He provided information on his professional background. He suggested that the optometrist might be the only doctor that a patient had access to because of Alaska's wide geographic distribution. He reported that a recent publication ranked Alaska 50th in access to health care. All health care providers should practice within the scope of their training. He supported the legislation due to its simplicity. It would replace the aging current optometry law that needed updating. He asserted the delay in updating the old optometry statute hindered access to eyecare and increased Medicaid travel costs in the state. Other prescribing professions such as dentistry and advanced practice nurses were regulated by their state board. The Board of Optometry ensured protection of the public and timely updates of practice. He thanked members for their support of the bill. He brought up the procedures that had been performed for decades by optometrists in their offices legally and safely in Alaska. He suggested that opposition had not familiarized themselves with current law. Treatment was an integral part of the profession. He thanked him for his time. Co-Chair Seaton asked if there was opposition to removing laser surgery from the scope of practice. Dr. Karpik responded that training and technology changed all the time. He thought the purpose of the bill was a durable statute that would stand the test of time like the state constitution. He was in favor of the current statute language in the bill. 4:18:44 PM JEFF GONNASON, CHAIR, ALASKA OPTOMETRY ASSOCIATION, ANCHORAGE (via teleconference), spoke in favor of HB 103. He was born and raised in Ketchikan and Craig and was the first Alaska Native optometrist. He practiced in Anchorage and performed clinics in the villages when he was a young man. He suggested that HB 103 did not authorize any optometrist to do anything. He relayed that of the four independent prescribing professions only optometry had been treated unfairly for several years. The Alaska Optometry Board deserved to receive the same level of trust as other health care professions. He opined that the optometry board would never authorize any practice outside the scope of education and training. Doctors of Optometry were held to the same standard of care as any medical provider treating patients. Section 5 of HB 103 was clear on the topic. The optometry practice definition in Section 6 was modeled after the exact wording from the Alaska dental statutes. Dr. Gonnason continued that two opposition arguments had prevailed over the course of the previous 40 years. The first argument was that optometrists were a danger to the public. The second argument was that optometry education was not adequate. He thought both arguments had been proven to be untrue. Optometry education and training was identical to the dentist model requiring 8 years to 10 years of university level education and residencies. Optometrists were real doctors. He relayed that optometrist had been prescribing medications for 25 years including prescribing scheduled narcotics for the past 10 years with no issues of harm. Alaska optometry supported limiting opioid use. Optometrists were defined as physicians under federal Medicare. There had never been a case of patient harm before the state optometry board involving prescriptions of treatment. Yet, over the past 40 years, the opposition had testified predicting terrible harm that never occurred. Dr. Gonnason argued that the clinical education of optometrists did not have to parallel that of an ophthalmologist any more than the education of a family physician having to parallel that of a neuro surgeon. He commented that optometrists and ophthalmologists did very little of the same things. Optometrists did not do any of the advanced specialty surgeries done by subspecialists. Rather, they did minor procedures in which they were competent. He suggested that surgery would be difficult to define in statute because technically anything that touched human tissue was surgery. He provided examples of surgery. He thought the definition should be in regulations rather than in statute to avoid having to come back to the legislature for changes. He pointed to a letter in member packets from a VA hospital where an optometrist did laser procedures with zero incidents of harm. He referred to an Oklahoma study which he thought was flawed. He was available for questions. 4:23:20 PM DR. GRIFF STEINER, SELF, ANCHORAGE (via teleconference), was an ophthalmologist in Anchorage. He read from a prepared statement: The ophthalmologists and others that oppose this bill (HB103) in no way want to prevent optometrists from practicing to the full extent of their specialty and training. This boils down to whether they intend to do surgery, which would truly be inappropriate. The bill should not pass as it currently written. If the optometrists want an autonomous board, but no surgery, then a concise definition of surgery can easily be added. If they oppose a definition of surgery, it can only mean they want to perform surgery. More than one optometrist has approached you indicating a desire to do a type of laser called YAG laser capsulotomy. They have not used these words, because capsulotomy means to cut a hole in the capsule. They instead have described this as "shining a light in the eye to clear up some clouding." But, the laser does not shine as it is invisible. The invisible light needs a second laser "HeNe" beam (Helium-neon) to focus the primary cutting laser. This laser cuts a hole in the membrane that holds the lens implant in place following cataract surgery (the removal of the natural lens when is has become cloudy). This is not a benign procedure, particularly in those without proper surgical training. This laser cuts a hole in a critical tissue in the eye and there is no shining involved. This is just one example, but is the first surgery they intend to approve. Ask them if they want to do surgery. It was not appropriate. Dr. Steiner was available for questions. Representative Wilson clarified that optometrists did the procedure currently. Dr. Steiner indicated that they did not do the procedure in Alaska. He thought only one or two states allowed it, Oklahoma and maybe Kentucky. He believed that it would be the first procedure approved by the Board of Optometrists. It was the type of procedure optometrists would advance into - something they have not been trained to do or have ever done. Representative Wilson asked if additional training had been offered in the two states he mentioned. Dr. Steiner was aware that a weekend course was offered on how to do a laser procedure. Following the training, optometrists were approved by their boards. 4:27:57 PM AT EASE 4:28:10 PM RECONVENED Co-Chair Foster CLOSED Public Testimony. Co-Chair Foster relayed that amendments were due by Monday, at 5:00 PM. HB 103 was HEARD and HELD in committee for further consideration. 4:28:35 PM AT EASE 4:31:48 PM RECONVENED Co-Chair Foster indicated that he was going to change the deadline for the amendments to HB 103. He relayed that they were now due by Friday, April 14th by noon.