HHES - 03/07/95 HB 168 - PERMITS FOR NONRESIDENT OPTOMETRISTS Number 070 CO-CHAIR TOOHEY said HB 168 was introduced by the House HESS Committee at the request of the Alaska Optometrists Association. This bill is very similar to Section 3 of HB 507, which passed the House last year with 39 "yeas" and one "absent." The bill was awaiting calendaring in the Senate Rules Committee when the session ended. CO-CHAIR TOOHEY explained that the passage of this bill would allow for a locum tenens permit to be issued to a nonresident optometrist for the purpose of assisting or substituting for an optometrist license under AS 08.72. Number 124 CO-CHAIR TOOHEY continued that Alaska has many solo practitioners in remote and semi-remote areas of the state. If the practitioner becomes injured, seriously ill or must leave temporarily, he or she presently must close down the clinic. This can be a hardship to patients, especially if the time away extends for several months. Also, this bill would allow for outside specialists in sub-normal visual therapy, etc., to be scheduled to assist local doctors with specialty care where this specialty care does not now exist. Number 182 DR. ROY BOX, optometrist, said the problem lies in the fact that there are only 50 optometrists practicing in the state of Alaska. Some of them are in locations which are difficult to service. If optometrists had the ability to do what physicians and dentists can now do, it would make it much easier to maintain an even practice flow when an optometrist is forced to leave town for any reason. These permits are not an uncommon idea in the provision of health care. This is just an addition to the privileges provided in the Alaska Optometric Act. Number 263 CATHERINE REARDON, Director, Division of Occupational Licensing (DOL), Department of Commerce, said the department is taking a neutral position on this bill and has submitted a zero fiscal note because it thinks it can absorb the costs of issuing these licenses. Ms. Reardon did want to bring one issue to the attention of the HESS Committee members. The Alaska statute permits Alaska licensed optometrists to prescribe drugs if they have received an additional certification. Some of the states from which the locum tenens optometrists will be coming may also have a prescribing provision for their optometrists. REPRESENTATIVE GARY DAVIS joined the meeting at 3:15 p.m. MS. REARDON continued that there was a question of whether these temporary optometrists should be able to prescribe drugs in Alaska if they have received training comparable to the Alaska requirements. Number 340 CO-CHAIR BUNDE asked what Ms. Reardon's recommendation would be to resolve this dilemma. MS. REARDON thought that language could be added which said if a person has received training comparable to the requirements of Alaska statute they may be granted the temporary right to prescribe drugs in Alaska. She offered to work on this language if it was the wish of the HESS Committee members. DR. BOX said there are now 41 states that license optometrists to prescribe drugs, and 5 more laws are pending. New Zealand and Australia were included in this bill because their laws are similar to Alaska's. In New Zealand, Dr. Box believes optometrists have the right to prescribe drugs, whereas in Australia they do not have those privileges. DR. BOX thinks that this could be handled in the board regulations that are written for the bill. He does not think that a person who is not licensed to prescribe drugs in his or her home area should be allowed that privilege in Alaska. Number 430 REPRESENTATIVE NORMAN ROKEBERG asked if this could be solved with a simple amendment to the effect that a person's training has to meet similar standards of Alaska optometrists. DR. BOX said currently, there are three classes of optometric licenses in Alaska. There are optometrists who are not licensed to use any drugs in their practice. There are those who are licensed only to use diagnostic drugs, so they may dilate pupils, etc. Finally, there are licenses to treat eye disease. Those classifications are going to slowly but surely go away because all new licensees must have a full education. These classifications were not grandfathered in when these laws were amended. DR. BOX expects that in five years, there will not be any optometrists practicing in Alaska that do not have a full therapeutic license. At this point, however, these classifications complicate things. Number 500 CO-CHAIR BUNDE thought language could be crafted concerning reciprocity, and stipulating that privileges must be similar to those allowed in the temporary optometrist's home state. However, Co-Chair Bunde would prefer it if Dr. Box and Ms. Reardon could bring this language back to the HESS Committee members at the next meeting. CO-CHAIR TOOHEY asked if Dr. Box and Ms. Reardon would work together on this task. Number 558 REPRESENTATIVE ROKEBERG was looking at the days of excused absence allowed for in HB 168. The bill allows for a maximum of 180 consecutive days of excused absence. He asked if there are situations in which there is educational programming that may go on for an entire school year, perhaps for nine months. He asked if the bill would be restrictive in this respect. DR. BOX said he did not think this would be a problem, and that 180 days would cover educational programs. REPRESENTATIVE ROKEBERG was concerned about the length of time used for post-graduate studies. DR. BOX said most post-graduate education courses offered are, at a maximum, two months long. CO-CHAIR TOOHEY announced that the bill was being held.