SB 270-DISPENSING OPTICIANS:EXTEND BD/REGULATION [This is a verbatim transcript.] VICE CHAIR HALCRO: Senate Bill 270, Board of Dispensing Opticians. We'll welcome to the committee Heather Brakes from Senator Therriault's office. Heather, welcome to the committee. Number 0070 HEATHER BRAKES: Thank you, Mr. Chairman and members of the committee. My name is Heather Brakes, staff to Senator Therriault and the Legislative Budget and Audit Committee, which is the sponsor of Senate Bill 270. Senate Bill 270 was drafted based on an audit ... conducted by the Legislative Audit Division and released by the Budget and Audit Committee on January 24th, 2002. The audit had several concerns about the board. One of those concerns was addressed in Recommendation Number 1 on page 7 of the audit report that's in your packet. The auditor stated in part, the disparity between the number of people who become licensed and the number of people registering to be apprentices suggests the 6,000-hour requirement for apprenticeship "may unduly prohibit people from getting licensed." The auditor suggested the board reconsider the necessity of the 6,000-hour requirement. MS. BRAKES: On page 13 of the audit, a table shows the number of both licensed dispensing opticians and those that have registered as apprentices. On page 15 of the report, the board response does agree with the auditor's recommendation, although in doing so, the board then wanted to add an $800 correspondence course to that requirement. We have not included that in our legislation and feel it would be a hardship to the employee and ... may even be shifted onto the employer. MS. BRAKES: Recommendation Number 2 of the audit addresses the board's state exam. The prior audit ... finding made in the 1995 sunset review recommended that the board improve the objectivity and consistency of the state's exam. After finding again that the board's exam process was flawed in several of the cases selected for review by the auditors, the auditors suggest the board give serious consideration to discontinuing the practical exam and require applicants to pass the nationally recognized examinations offered. Those examinations are incorporated in Senate Bill 270. MS. BRAKES: The auditors continue to be concerned about the apparent subjectivity or error-prone nature of the exam. On page 11, fourth paragraph down, the auditors found in part: "The board has not resolved the prior sunset audit recommendation related to the state practical examination. The objectivity and consistency of the state practical examination did not improve over the current sunset review period, resulting in successful challenges by applicants who originally were determined to have failed the test." The board has offered several solutions to the problem, we feel at this time -- none of which fully resolve the situation. MS. BRAKES: Under the Auditor Comments section of the report, the auditor makes the assessment that moving to a "register" system and eliminating the board may have merit. Although Senate Bill 270 does not do that, it is something the legislature may wish to consider in the future. Currently, 22 states license through regulatory boards; the remaining either use a register system or do not regulate dispensing opticians at all. With that, Senate Bill 270 extends the board for three years, in contrast to the normal four-year extension. It reduces the number of apprenticeship hours from 6,000 to 3,000 and accepts an associate's degree in opticianry ... in place of any of the apprenticeship hours. It removes the state's practical exam and replaces it with acceptable passage of the national examinations. And with that, I would conclude my testimony. Pat Davidson, the legislative auditor, is here to answer any specific questions to the audit, and Catherine Reardon is here as well. VICE CHAIR HALCRO: Thank you very much, Heather. Any questions for Ms. Brakes? Seeing none, Catherine I'm going to hold you till last. Let's go [to] teleconference, to the Fairbanks LIO [Legislative Information Office], James Rothmeyer. Mr. Rothmeyer, are you online? JAMES ROTHMEYER: Hello. VICE CHAIR HALCRO: Yes. If you could state your name and affiliation for the record, please, and please keep your testimony to under three minutes. MR. ROTHMEYER: Certainly. My name is Jim Rothmeyer. I'm the Chair of the State Board of Dispensing Opticians. VICE CHAIR HALCRO: Did you have any testimonies, Mr. Rothmeyer, or were you just ...? MR. ROTHMEYER: Yes, I had a couple of comments and testimony. VICE CHAIR HALCRO: Please proceed. Number 0442 MR. ROTHMEYER: In regards to the ... 6,000-hour requirement, just reducing the hours from 6,000 to ... 3,000 hours makes not much sense to me without adding an education-and-training program such as the Career [Progressions] Program by the National Academy of Opticianry. And just reducing the apprenticeship hours, these applicants would undoubtedly [be] even worse-prepared and trained than they are now. As far as the state examination goes, it's a key element in having applicants demonstrate their ability, or lack of, in performing routine tasks needed to ensure their proper accuracy, and in some cases, the safety standards of spectacles/materials dispensed. I think we need to ... be able to have professional oversight, peer review, to maintain quality and standards that the public expects and deserves. Thank you. VICE CHAIR HALCRO: Thank you very much, Mr. Rothmeyer. Is there any questions? Seeing none, next we'll go to the Mat-Su LIO. Roberta Rawcliffe, are you online? Roberta Rawcliffe. We will come back to the Mat-Su LIO. Catherine Reardon. Heather, if you'll just stay at the table, that'd be great. Number 0538 CATHERINE REARDON: Thank you. For the record, this is Catherine Reardon, Director of the Division of Occupational Licensing in Department of Community and Economic Development. And my division staffs the Board of Dispensing Opticians. I will try to be brief and yet mention a few issues I think may be relevant to this legislation. The division does support the extension of the Board of Dispensing Opticians. And there are two remaining issues that Mr. Rothmeyer referred to. And with your indulgence, I'd ask you to ... consider amendments that relate to them that -- I realize it's not my role to offer amendments, but to consider this possibility, and there is some text that you have on the table. [The two amendments provided by Ms. Reardon read as follows, with original punctuation: Amendment No. 1  Page 3, line 13: Insert a new paragraph to read: (4) has successfully completed a career progression program required by the board in regulation; Renumber the remaining paragraph Page 3, line 14 Amend to read: (b) Graduation from an associate degree program in a recognized school or college of opticianry may be substituted for [4,000 OF THE 6,000 HOURS OF EXPERIENCE REQUIRED BY (a)(2)] the requirement of (a)(2) and (a)(4) of this section. Page 3, line 31 Add a new section to read: AS 08.71.165. Assistants.  A person who is not a licensed dispensing optician may assist a licensed physician, optometrist or dispensing optician. The person may perform dispensing optician tasks that have been specifically delegated by, and are performed under the direct supervision of, the licensed physician, optometrist or dispensing optician. The person may not use a title including the word "optician or "opticianry." Amendment No. 2  Page 2, line 19 After "shall" add "pass a practical examination given by the board and" Page 2, line 24 After "shall" add "pass a practical examination given by the board and" Delete Sections 2 and 6 (end of Ms. Reardon's proposed amendments)] Number 0563 MS. REARDON: These two issues are the ... practical exam. The board feels the practical exam is important to ... determine if people are qualified to work as dispensing opticians, because the written national examinations, although good, are written tests, and they'd like to know that the applicants have the ability to use the machinery that's involved and do the practical skills. There have been difficulties at times in administering the practical exam in an exactly equivalent manner - not through any bad intent, but through sometimes the difficulty of creating the exact same situation with equipment for applicants. But the board feels that they've been working to improve the exam, that they should be able to continue offering it or to contract out to the private sector to offer it. MS. REARDON: If ... the committee feels that the practical exam should be permitted to continue for the next three years, I do have draft language that would - ... if you have my text, it's called Amendment 2 - ... do that. Another alternative, either with that or instead of it, is perhaps a letter of intent that would say that the board should study the options for practical exams for the next couple years - two years - and report back to the legislature so that those recommendations could be considered in the next audit process. The point of doing that would be that it would kind of keep the idea of a practical exam alive, give the board a task to try to find a fair, easy-to- administer practical exam. The idea ... would come back again at the next sunset audit and wouldn't be lost to history, and would give the board the ability to feel like it was still able to engage in the debate over the exam, even if you eliminate it for the next couple of years. And that's what the one-paragraph letter of intent says. Number 0704 MS. REARDON: The other important issue was referred to by Mr. Rothmeyer, ... the board's desire that applicants for licensure get some education in addition to their apprenticeship hours. The bill reduces apprenticeship hours by half. A thousand hours is about six months. So the apprenticeship is going from three years to a year and a half. And the board would be okay with that if ... there were some education that was going to be required. There is a program called the Career Progression Program - there's a pamphlet there on it, on the table - which is a correspondence course that the board feels would really improve the knowledge of applicants for dispensing optician licenses, and would prepare them to better pass the ... national exam. It is $800, as referred to by Ms. Brakes. The initial proposal by the board had been to require this of all apprentices, but the new proposal is that it be required to get a license. MS. REARDON: But here is the significant difference: that today, if you're going to work as an assistant to an optometrist, of a ophthalmologist or an optician, if you are going to do "dispensing optician" in a supervised capacity, as an assistant - you must register as an apprentice. The proposal here is to do away with that requirement that you're going to be an apprentice. If you don't wish to be an apprentice and you don't wish to work towards licensure, you ... don't have to. That's a big concession on the part of the board, because this has been an age-old battle between the optometrists and the opticians: that optometrists' employees have to register as opticians. Number 0812 MS. REARDON: This - what I have here is Amendment 1 - would say that you can be an assistant without being an apprentice, but if you choose to go on and work towards licensure, sign yourself up as an apprentice and take the Career Progression Program. And the reason this is a significant kind of perhaps solution to situations that have been going on with opticianry is because at the current time it seems like -- the law reads that you have to have a dispensing-optician license to do dispensing opticianry unless you are a student - kind of like a student hairdresser can cut hair - unless you are an apprentice. But that apprentice system seems to have evolved from being students who want to be licensed to being techs, paraprofessionals - like your pharmacy tech or a vet tech, people who don't necessarily want to go on. But because the system was set up anticipating that apprentices were people who wanted to go on, there hasn't been a way for people who want to stay techs and just have this job of being a tech. To do it legally, we were forcing them to get apprentice licenses, causing tension with the optometrists and the physicians who also employ these techs. MS. REARDON: And so this offering would say, "Recognize that ... a lot of people who are apprentices now are really techs, don't want to get a license, let them not pay us money; let them just be techs under supervision. But the ones who really are apprentices and who really do want to train up, have them take the Career Progression Program, get the education as well as this reduced number of hours so they will be better qualified to pass the test." And I ... want to set that before you, because it ... seems like a - in certain ways to me - a major concession of something that has been a long battle. And it is my understanding, kind of through a third source, that this [is] something that the board can ... accept. So ... VICE CHAIR HALCRO: Thank you. Any questions for Ms. Reardon? Representative Crawford. Number 0928 REPRESENTATIVE CRAWFORD: Thank you, Mr. Chairman. It seems to me that we're on uncharted ground here, and that there could be some unintended consequences if we ... go this way. I mean, it's definitely going to be a change. How do we compare with other states? And do they have techs? Do they have apprentices? Is 6,000 hours ... the norm or 3,000 hours the norm? ... How do we compare with other ... states? MS. REARDON: Through the chair, Representative. I believe that quite a few other states do have an apprenticeship requirement to get licensed. I think the leg [legislative] auditor may be more knowledgeable, but I've heard her testify in the past about the length of time for apprenticeship. But they do ... vary from state to state, that at our current 6,000 hours prior to this bill, which reduces it 3,000, ... we're probably towards the upper end, but we're in the range that ... states that have licensing boards tend to require ... more towards the upper end. States with registration maybe tend to go towards the lower end. And so, ... by coming under 3,000 hours, we're definitely at the upper end anymore of apprenticeship requirements. But most do require apprenticeship. MS. REARDON: I think that the Career Progression Program is becoming increasingly kind of popular in the states. Mr. Rothmeyer may be able to speak to that because he's the chair of the board. But ... it's a correspondence course that's been developed by ... the profession. And I think that there wasn't really a good way of getting people trained up. There wasn't a real good correspondence course before that, so I think it's going to be more and more appealing. And I think, in terms of the techs -- I use the word tech or assistance; it's really an unlicensed person who is doing delegated supervised work, and use the term tech because I thought it might help everyone understand it. I don't know in how many states you're allowed to do any dispensing opticianry without having the dispensing- optician license, but I do know that there are several states who don't require any dispensing-optician license. So, if that gives you any comfort? It's ... not a profession that is required to have a license in every state, like doctors or, you know, or dentists or something like that. I know you want to keep moving, so.... VICE CHAIR HALCRO: Any other questions for Ms. Reardon? Ms. Brakes, did you have a comment? Number 1072 MS. BRAKES: Yes, thank you, Mr. Chairman. Representative Crawford: on page 7 of the audit, under "Findings and Recommendations", the auditor says currently 22 states regulate opticians through the use of a licensing board. The remaining states either utilize a registration system or [do not] regulate them...." And then it goes on to talk about apprenticeship programs; some have requirements as low as 2,000 or 3,000 hours. MS. REARDON: With your final indulgence. You know, if you were so inclined, you might ... hold it over and look at these, see if you want to do a CS or something. I know it's a lot to have to decide in three minutes, being thrown at you by me, but.... VICE CHAIR HALCRO: Let me ask, Ms. Brakes, as the sponsor's representative: have you had a chance to look at these amendments in any prior committees? MS. BRAKES: No, these were just handed to me right before the meeting started. VICE CHAIR HALCRO: Any comments on them, or their impact on the legislation? MS. BRAKES: Actually, I would like to have Pat Davidson maybe answer. VICE CHAIR HALCRO: Pat, would you come to the table, please? Thanks. Number 1137 PAT DAVIDSON: For the record, Mr. Chairman, my name is Pat Davidson, Legislative Auditor. I, too, just took a look at these. And while I ... probably have more questions than answers with regard to this, one of them has to do with assistance. And as Ms. Reardon said, there has been conflict between ophthalmologists, optometrists, and dispensing opticians with regard to supervision requirements of the ... dispensing optician apprentices. It's ... unclear to me right now, the suggested wording regarding assistance. It talks about having these individuals under the direct supervision. Since these are people who are not licensees, aren't apprentices of a dispensing optician, who would be setting the criteria for what direct supervision means? Right now, because they're the apprentices, it's the dispensing-opticians statutes and regulations that define how these people are to be supervised. When you move them out of being apprentices of the Dispensing Optician Board, does that mean the direct supervision needs to be defined in the statutes for the ophthalmologists, the optometrists, as well as dispensing opticians? Those are just questions that I have looking at this. So -- and I apologize for raising questions instead of providing answers. VICE CHAIR HALCRO: And that's certainly okay, judging the lateness of the receipt of these amendments. Let me ask you: Ms. Reardon indicated that another option might be to provide a letter of intent - in addition, obviously, as we pass the extending the sunset date - a letter of intent saying the board should take a look for the next two years at the practical exam and the benefits thereof. Does that sound like maybe a better alternative than ... taking the amendment direction? MS. DAVIDSON: Mr. Chairman, it probably doesn't ... stick out very well in the report, but when we say that this is a prior audit finding, this means this is an issue that has been before the board for not only this last four-year period, but the four- year period before. So, this isn't anything that has been dropped. It isn't anything new to the board. This is something they knew we had concerns with years ago. We look at it; it's not improved. The legislation takes the action and says, "Okay, you've had eight years. We're moving away from a practical exam to a national exam." And yes, we are moving from a practical to more of a written exam. MS. DAVIDSON: But there are alternatives, if you're concerned about the quality of work that they're doing. There would be ways to put requirements on the type of work that they need to do, whether or not the individual supervising them has to sign off that, in their belief, they do meet the requirements and can fulfill these things. There's different ways to get around having a practical exam. And, as I said, it has [been] before the board, and it's nothing new. Number 1326 VICE CHAIR HALCRO: Ms. Brakes, since these amendments have been dropped on you today, would ... it be better, maybe, if we gave you a couple of days to work with the department in taking a look at these amendments and how they fit into, obviously, the piece of legislation you've been working through ... for a while now? Would that be a better alternative? It seems to me that we're kind of caught off guard by these amendments, and it's kind of a change in direction. Would that work a little bit better for you? And then possibly we could bring the bill up next week. ... Would that be okay? MS. BRAKES: Yes, Mr. Chairman. VICE CHAIR HALCRO: Okay, because I certainly don't want ... to rush the discussion, and I want to give the sponsor time to take a look at ... the amendments. Do we have any other questions for either Ms. Brakes or Ms. Davidson? Thank you very much. We're going to go back online now to Mat-Su. Roberta Rawcliffe. Roberta, welcome to the committee. If you could state your name and affiliation for the record, please. Number 1370 ROBERTA RAWCLIFFE: Certainly, Mr. Chairman and the members of the House Labor and Commerce Committee. I'm Roberta Rawcliffe and the publicly appointed member of the Board of Dispensing Opticians. VICE CHAIR HALCRO: And did you have any comments, or were you just online to answer questions, ma'am? MS. RAWCLIFFE: No, I do have a few comments, if I could have a few moments of your time. VICE CHAIR HALCRO: Absolutely. Please proceed. Number 1395 MS. RAWCLIFFE: Appreciate it. I was appointed by Governor Knowles to the board on March 8, 1999, to represent the public interest as it relates to opticianry. I'm a mortgage banker by trade, but I take my appointment and my obligation to the public in this matter very seriously. And that's why I'm here. And I would ask the committee to amend SB 270 in the following ways for the following reasons. Number one, Section 1, AS 08.03.401(c)(9): I would ask that the committee consider making the sunset date for the State Board of Opticianry coincide with the June 30th, 2006, date of the State Board of Optometry, since they are like industries and have like ... obligations to the public - that those dates would be concurrent. MS. RAWCLIFFE: Additionally, I would like to put in my two cents on the examination. I believe that the practical examination should be retained for the public good. Now, I've been on the board since '99, and the board has been working very, very hard at trying to iron out the problems that ... were inherent in the way the exam had been designed. There's been a total redesign of the exam for this year, taking into consideration the legislative auditor's recommendations and findings that there was ... a fair amount of subjectiveness in the examination. The way it had been written before, it was prone to interpretation and it was prone to mathematic errors on the part of the board members as they were grading it. And as a result, there were ... three ... disputes over what these scores were and whether or not those people who had sat for the examination shouldn't be "delighted." The examination, the way it's being administered next week on Thursday, is ... totally redesigned so that the subjectiveness of the answers is taken out, and the questions are now multiple-choice. And the ... lenses and whatnot which will be set before the examinees are all lab-tested so there's no going to be in question as to whether or not these are or aren't the readings that someone might otherwise make. MS. RAWCLIFFE: From the public's standpoint, I think that the practical examination is necessary because it's very easy for someone ... to be "book smart" and not ... necessarily have the practical skills to carry out their duties. And in the case of issuing glasses or lenses or any other eyewear including contact lenses, it seems reasonable to me, as a nonindustry person, that someone could pass the written examination and be signed by a supervisor who does or doesn't necessarily watch everything that goes in and out of the shop, especially if it's a shop that doesn't do a lot of its own work but sends things out to the laboratory to be done. In that case, if someone comes in with some eyewear that needs to be created for them, if that person doesn't have a practical, hands-on experience to do it, how do we know that what they're doing is correct? And in the case of small children, if those lenses are done poorly, they can do irreparable harm. So I disagree with the ... notion that book learning is sufficient. Number 1559 MS. RAWCLIFFE: Secondly, on the apprenticeship issue: as a board, we have discussed waiving, possibly, the mandatory registration for those who don't want to be licensed. The issue comes down to what you call them and what are their duties, as Ms. Reardon raised that issue. If all they want to do is clerical work or help customers choose frames, or hand over lenses which have already been checked out by the optician or the licensed apprentice to prove that they are indeed the prescription which was ordered by the optometrist or the ophthalmologist, I have, personally, no problem with that. And I think it makes good sense; there's no point in taking someone who doesn't have the desire to move forward in the field and making them quit their job if they haven't sat for an examination after 6,000 hours of work. MS. RAWCLIFFE: On the other hand, if you have someone who has been an apprentice for 6,000 hours and they still can't pass the examination, there's something radically wrong. And as a public person, I think it's good that they are weeded out, right then and there, you know, rather than just being people who are basically being used as sales people. So, ... my personal belief is that if there were two levels of people in the shop: ... the licensed people, whether it's the opticians or the licensed apprentices; and ... those people who fill in as a clerical or a sales function, ... and they have no impact on the actual lenses that are -- or the reading of the prescription and the manufacturing of those lenses. I have absolutely no problem with that. I can't speak for other members of the board, directly. But the consensus in our last meeting was fairly positive, and I think that might be something that the auditor would find of interest, since it was one of the major concerns in the last legislative audit. Number 1653 MS. RAWCLIFFE: Finally, I'd like to say that the Career Progression Program, which is ... basically a distance-learning program for those who would like to become licensed in Alaska, is, I feel, a very necessary and very worthwhile course. I've seen one course which is ... currently available on the market and is excellent. Because we live so far away, there is no school of opticianry in Alaska. Many states have schools of opticianry, and some of the states that don't require ... apprenticeships are fortunate enough to have schools of opticianry ... in their state, so that those people who want to make this a career can get the schooling. We don't have that opportunity to afford the people here, so this is the next best thing we could do. We looked at the number of hours for an apprentice to be able to sit for an examination, and felt that it is excessive if all they're doing is working for 6,000 hours or three years. Why not also have them put in the time into the Career Progression Program so that they could sit for the examination sooner, and hopefully increase the number of licensed opticians in the state, which further benefits the public good. And that is about all I have to say, and I certainly appreciate your giving me the opportunity, sir, to do it. VICE CHAIR HALCRO: Well, thank you for your testimony. We appreciate you being with us today. Is there any questions? Seeing none, Representative Kott, you had a question for, I believe, ... either Ms. Davidson or Ms. Brakes. Number 1722 REPRESENTATIVE KOTT: I had a question for Ms. Reardon. Catherine, on the Amendment 2, at the bottom, it says, "Delete Sections 2 and 6". Is that the intent, to delete the section dealing with the ... duties and powers of the board, or have I missed something? MS. REARDON: Through the chair, Representative. No, that would mean that ... the current powers-and-duties statute would not be changed. There'd be no need to amend it, because the purpose for Section 2 was to take the word "examine and" out. And so, if we were going to keep the examination, you wouldn't need to be eliminating that. And the same thing with Section 6: the purpose of Section 6 being in the bill was to eliminate the term "examination fee". If we weren't going to have the exam, you wouldn't need that section. REPRESENTATIVE KOTT: Thank you for that clarification. VICE CHAIR HALCRO: Any other questions for Ms. Reardon? Seeing none, what we will do is we will set this bill aside until such time as the sponsor and the department have had time to sit down and reconcile the amendments and wait for further word. So, I really appreciate everybody being here, and we'll just put this aside for now. [SB 270 was held over.]