HB 502-DISPENSING OPTICIANS: BOARD & REGULATION CHAIR ANDERSON announced that the next order of business would be HOUSE BILL NO. 502, "An Act relating to dispensing opticians and dispensing optician apprentices." Number 1575 REPRESENTATIVE JIM HOLM, as the sponsor, introduced HB 502. He testified: At the request of the Opticians Association of Alaska I brought forth House Bill 502. House Bill 502 clarifies the education and training requirements to become an optician in Alaska and it allows qualified opticians from other states to practice here. It sets out the requirements to fit and sell contact lenses and this bill also transfers the optician's apprenticeship program to the U.S. Department of Labor. Currently, the amount of training does not meet the threshold for the Department of Labor and so, the state of Alaska needs to be put on a par with other states and require a higher amount of training than they do presently. The current statute is unclear and inadequate. House Bill 502 puts specific qualifications on the amount of hours that an optician must have to qualify for both spectacles and contact lenses. ... This legislation raises the amount of hours that are required to at least 4,000 hours of training to dispense eyeglasses, and at least 2,000 more hours to dispense contact lenses. The distinction clarifies language and requires an appropriate amount of training for the opticians in Alaska to effectively serve the public. This morning I received an email I wanted to share with you, which I thought was quite interesting. The person [Robin Marquiss, licensed optician] told me that [original punctuation provided], "The requirements for licensed opticians need to be increased. In the state of Alaska, a hairdresser is licensed after working 2000 hours or attending 1650 hours of a training school. Are we sending the message that someone flying our airplanes or driving our highways with the incorrect eyeglasses is less a threat to the public than a bad haircut????" I think the point is made that we need [to] maybe change what we currently have as a requirement. I believe it's 1,850 hours. In your packet you should have the ... legislative audit [done by Pat Davidson, CPA, 10/02/03] [which] recommends ... allowing the sunset of the board of opticians [Board of Dispensing Opticians], but it makes a clear distinction between the amount of training required to dispense eyeglasses and contact lenses. In addition, in your packet are some requirements from other states. ... When they talk about three years - and you assume that somebody works 40 hours a week for a year - they work at least 2,000 hours a year. You're looking at 6,000 hours of requirement of apprenticeship in order to be a licensed optician in other states. Not all of them are the same ... most of them are three years or thereabouts. Number 1760 REPRESENTATIVE GATTO referred to page 2, line 29, "Licensure by credentials. A person with a valid license as a dispensing optician from another state, territory, etc." He expressed concern that Alaska might accept reciprocity from a state with a low level of required hours. REPRESENTATIVE HOLM replied that he could not speak to this but he suspected there would be forthcoming testimony that could. Number 1837 FRANK ROZAK, Secretary-Treasurer, the National Association of Optometrists and Opticians, a trade group with several of its members with stores in Alaska, including Sears Optical, Lens Crafters, U.S. Vision, testified: We concur with the primary recommendation of the Legislative Budget and Audit Committee report, dated October 2, 2003, to replace licensure with a registration program. Why is that? In addition to the reasons that they've outlined, and as a national trade association, I can tell you that there are only 22 states which require licensure for opticians; 28 do not, despite repeated efforts to convince legislatures to do so. The Departments of Health in Colorado, Kansas, and Minnesota, in formal, written reports, advised against the need to license opticians. They found no public health or protection benefits; they found an adequate, existing training, and numerous means for customer redress of problems, and an economic disadvantage for customers. That's a summary of those reports. I was interested in the earlier conversation about the legislation dealing with employees, and employers, and court dates, and all the rest. On page 20 of the legislative audit report it shows as of 2003, a total of 107 dispensing opticians. Ladies and gentlemen, if one of our licensed dispensing opticians had to go to court for a couple of days, much less a couple of weeks, we would be out of business, because there is a huge manpower shortage in the state of Alaska for licensed dispensing opticians. Couple that with the board's recent new regulation dealing with supervision - which, as I understand it, contravenes the definition of supervision which the legislature passed in 2002 - it makes it even more restrictive. So who is the beneficiary? What happens to the vision care consumer who orders a pair of glasses, or wants to order a pair of glasses and cannot, because the licensed dispensing optician is not there because he or she is in court? Unfortunately, we have a huge manpower problem for opticians in the state of Alaska. I suspect part of it is related to the rules, regulations dealing with entry into the occupation and profession. Number 1955 MR. ROZAK continued: The House Bill 502 seems to ignore the Legislative Audit and Budget Committee's report, and candidly, in my judgment, heads down a totally opposite road. It provides for more regulation rather than less. Just quickly, I want to address the issue of contact lenses. On February 4th, legislation which was passed in the U.S. Congress, House Resolution 3140, entitled the ... [Fairness to Contact Lens Consumers Act], provided that a consumer, after a final fitting of their contact lenses, shall be entitled to a copy of their prescription. If any of us can believe it, there are a number of states which prohibited the consumer from getting a copy of his or her contact lenses prescription, even after they paid for it. It also allows non-licensed sellers, referring to mail order contact lenses firms and Internet providers who are not regulated or licensed in any jurisdiction, to sell contact lenses. While this bill would require 2,000 hours of training - and that's in Section 3, [subsection] (a), [paragraph] (2), at line 16 - for the same persons to be able to sell contact lenses in Alaska, and that would be after passing a written exam. Essentially, what we are doing is we are allowing another competitor, a mail order contact lenses firm or an internet provider, who's not licensed or regulated at all, to sell contact lenses to Alaskan consumers, but Alaska opticians and Alaskan optical firms would have to have employees meeting a 2,000 hour requirement plus passing a written exam. That is not a fair, nor level, playing field. Number 2045 MR. ROZAK stated he believes HB 502 would contribute to the current shortage of qualified [opticians] and provide less competition to the current license holders. In order to meet the needs of the average Alaskan family and be open on Saturdays, holidays, and evenings, a licensed optician should be on the premises of the business. However, without enough opticians, such hours can't be provided. This isn't in the best interest of the public, he stated. REPRESENTATIVE CRAWFORD asked Mr. Rozak how many optician apprentices and trainees there are in Alaska. MR. ROZAK, in response to Representative Crawford, related that the Legislative Audit of the Board of Dispensing Opticians specifies there are 191 optician apprentices and trainees in Alaska. Mr. Rozak identified the key issue as the definition of "supervision." He explained that if the [Board of Dispensing Opticians'] definition was consonant with the legislature's definition, which is based on the 2002 statutes, it would be [acceptable]. However, the board's definition of "supervision" essentially provides for on-site supervision. Therefore, if the licensed optician isn't there, the apprentice is unable to participate in any of the tasks related to opticianry. MR. ROZAK reiterated that requiring apprentices to be supervised by licensed dispensing opticians is the root problem, since it limits the scope of work an apprentice can do. REPRESENTATIVE CRAWFORD expressed that he was confused and asked, "If the licensed optician is not there, and you were just saying that you are out of business if you don't have one, how are these people not getting the training that they need, if those opticians are actually there when your business is operating?" Number 2168 MR. ROZAK replied: When the opticians are there, then the apprentice can engage in those tasks and functions which the licensed optician says that person ... can engage in. On the other hand, if the licensed optician is sick, then that licensed apprentice can't do anything that's related to the dispensing of eyeglasses or contact lenses unless the licensed optician is present. It is a very difficult situation when a licensed optician in one store gets sick. We try to have some extra opticians that are on call or come from another store that has higher volume in order so that we can stay open. REPRESENTATIVE CRAWFORD commented, "You have almost twice as many apprentices coming on as you have licensed opticians today. I don't know what your projected demand would be, but it sounds like your apprentices are going to be taking care of the demand in the future." MR. ROZAK responded: The problem is that there are a lot of apprentices - despite intensive training efforts by the licensed dispensing opticians, and candidly by the various companies - who choose not to ever take the exam to become licensed dispensing opticians, or have tried and have failed for whatever reason, and have become discouraged [and], therefore, remain as apprentices ad infinitum. We would like to open up several more stores, but given the fact that there is a crunch in terms of licensed dispensing opticians, ... we can't do it. We would be unable to be open all store hours. ... There are times during the day when customers cannot get eyeglasses because the licensed optician is not there and the apprentice is not permitted to engage in optical dispensing unless the apprentice [optician] is there. Number 2275 In fiscal year 2000, a total of two opticians were licensed. In fiscal year 2001, three; again three in fiscal year 2002, and only four in fiscal year 2003, despite the fact that there was an increase in the number of apprentices during those years. It demonstrates that apprentices don't necessarily become licensed. That's the problem that we are [experiencing], and we suspect others are, too. REPRESENTATIVE CRAWFORD asked Mr. Rozak what the average wage for a dispensing optician and an apprentice would be. MR. ROZAK estimated that the average wage of an optician would be in the $15 to $20 range and for apprentices would be paid significantly less. REPRESENTATIVE CRAWFORD expressed amazement at the small numbers of apprentices that actually became licensed. He noted his experience with ironworkers. [Tape ends mid-sentence.] TAPE 04-36, SIDE B  Number 2401 REPRESENTATIVE CRAWFORD continued discussing the ironworker's apprenticeship and said, "We end up graduating more than half of those at the end of their four years - they'll become journeymen ironworkers." MR. ROZAK admitted, "There's something terribly wrong when you have 40 apprentices in the year 2000 and only two of them become licensed. I suspect part of the problem is training, but ... also ... the nature of the examinations and the perhaps the scoring of those examinations. I don't know whether the examinations are constructed and are valid." REPRESENTATIVE CRAWFORD stated, "I feel like there's something else underlying here that we're not seeing." Number 2305 MR. ROZAK replied: Someone other than myself said that sometimes regulatory boards are guilty, sort of being like the fox guarding the chicken coup. It certainly would not surprise anybody that a particular occupation or profession that controls a licensing board would want to have lesser numbers of people licensed rather than more, because it, in essence, creates competition for those who've already got the license. Number 2289 REPRESENTATIVE GUTTENBERG asked if there was a sliding scale of responsibility that corresponded with the number of hours worked in an apprenticeship program. MR. ROZAK, drawing on his experience, explained that in the first weeks of an apprenticeship, individuals are performing basic tasks such as answering the phone and making appointments. However, those individuals who have completed 75 percent of the apprenticeship and who the licensed optician believes to be capable of performing nearly all the tasks related to dispensing and selling eyeglasses, are restricted from doing such tasks if the licensed optician isn't present. REPRESENTATIVE GUTTENBERG asked what the National Association of Optometrists and Opticians does to help apprentices pass the examination. MR. ROZAK replied that that is the individual responsibility of each of the association's members. He stated, "As an association, we do not have an education program, other than for continuing education. We do not have an apprenticeship program, per se." Number 2218 REPRESENTATIVE DAHLSTROM asked what state Mr. Rozak is from, if that state was one of the 22 states that did require licensure of opticians, what position he holds in his association, and if he finds anything in the bill that is relevant. MR. ROZAK answered that he believes [the legislation] is relevant. He informed the committee that he is from the State of Ohio, which licenses opticians. He also informed the committee that he serves as the secretary-treasurer of the National Association of Optometrists and Opticians. Mr. Rozak mentioned that in his "prior life" he was the vice president of government relations for Cole National Corporation, which operated the optical departments at [Sears, Roebuck and Co.], Pearle Vision, and Target [Corporation} Optical Stores. MR. ROZAK, turning to the legislation, opined that replacing the current board-operated apprenticeship program with the United States Department of Labor apprenticeship program is "a good move." Furthermore, the licensure by credentials in Section 4 will hopefully add new dispensing opticians. Also, prohibiting unlicensed persons from selling contact lenses of any type is appropriate because doing so is dangerous. Mr. Rozak highlighted that, irrespective of the number of hours [of apprenticeship], one still has to pass an examination, which he indicated should be the determinant of competency. Number 2072 MR. ROZAK stated he does not believe there is any empirical evidence to justify increasing the number of training hours from 1,800 [to 4,000 hours] for apprentices. He said that passing the examination "should be the crucible in order to determine competency." REPRESENTATIVE LYNN asked Mr. Rozak to outline the basic training for an apprentice and how their work is portioned out. MR. ROZAK clarified that the person who grinds the lenses or makes the contact lenses isn't licensed under this regulatory scheme. Mr. Rozak opined that the most important lesson for an apprentice or licensed optician is the ability to interpret a prescription. However, the fitting is artistic and "in part function". Number 1918 LARRY HARPER, Member, Board of Dispensing Opticians, Vice- Chairman, American Board of Opticianry (ABO); Board Member, Contact Lens Society of America (CLSA), testified. He noted that he is also past President of the Opticians Association of Alaska; past President of the Opticians Association of America, and served on the Board of National Contact Lens Examiners (NCLE) for approximately nine years, a board that certifies contact lens fitters throughout the United States. He stated: My involvement in my profession started in 1973 with the passage of this licensing statute and, while I cannot claim to be the father of this legislation, I was certainly in the delivery room when it got here. I come here to testify today on behalf of [HB] 502 because I think it does a lot of things that will help to clear up the statute, help to put it in agreement with other statutes, namely the optometry statute. It makes clear some of the changes that were made two years ago. Number 1849 There's enough questions that have been brought up that really should be ... answered. ... The document that I think Mr. Rozak is reading from is not up to date, because in 2002, two years ago, this legislature changed the requirements for optician's apprentices. They also created a new category called an optician's assistant. Now Mr. Rozak's client stores, and every vendor of optical goods and services, has the right to put as many of these optician's assistants into function as sales associates or opticians delegated by authority, and have no restriction on their supervision, whatsoever. If you read the statute carefully, it says the definition of supervision, as it applies to apprentices. What we are looking at in an apprenticeship is a training supervision situation for someone who wants to become a career optician. Quite frankly, we found several years ago when my friend Jim Rothmeyer and I were both appointed to this board, that the setup that was ongoing as far as the apprenticeship was absolutely horrendous ... The training was absolutely horrible. We started to work within the confines of the board; found that that was not going to be the vehicle that we needed. We went to the [U.S.] Department of Labor who has a whole division and personnel setup to help people in professions and trades in this type of situation. MR. HARPER compared the previous, "horrible" apprenticeship program with the current one that involves a distance-learning program that's available statewide, with the practitioners assuming the responsibility of supervision while training apprentices. He noted, "Supervision has the same meaning as in AS 08.71.240, and ... it has to do with admitted direction and control as deemed necessary. There is nothing to do with direct, on-premises, supervision. MR. HARPER replied to the previous question about increasing levels of responsibility, stating that the longer the apprenticeship continues, the more responsibilities the apprentice takes on. He cited government and trade association studies as containing information that supports increasing the hours of training for apprentices. He indicated that 1,800 hours is insufficient time to cover the necessary information in an apprenticeship program, and noted that the Commission of Opticianry (COA) accreditation [lists] government-approved schools that require an associate degree program that is two years in duration. Number 1650 MR. HARPER testified: Why take a program that has worked so very well for 31 years, even though it's got some inequities and problems with it, and dismantle it, in order to get what? Quite frankly, the wage difference from someone who knows what they are doing and who is well trained in full scope opticianry, yes, is going to knock down that horrendously high wage of $15 to $20 a hour in the state of Alaska. Take the licensing away and they'll probably be making $10 an hour or $12 an hour. If you were a practitioner in the state of Alaska right now, you can fill your whole establishment up with those level knowledge people. There's not a thing stopping you doing that. The legislature lowered the hours; they lowered the requirements for supervision, so that we would not interfere with a person's right to do business in whatever modality they saw fit. This was brought on, basically, by a burning desire on the part of optometry to get licensed opticians - I shouldn't say out of their offices - but not make it a requirement in their offices. Since then, the requirement has been 1,800 hours; it has been to pass a distance learning program course for spectacles and for contact lenses, and to establish yourself with the examination criteria from the American Board of Opticianry or the National Contact Lense Examiners, if you so desire to become licensed in contact lenses. From that standpoint, I think we've got the mechanism for producing the types of opticians that I think we want helping our general eye care population. Number 1548 REPRESENTATIVE DAHLSTROM asked where Mr. Harper lived and if he was familiar with the legislative audit. She referred the committee to page 6, where reference was made to the Board of Dispensing Opticians' deficit of $22,000, and she asked Mr. Harper how this deficit arose, and what had to happen to eliminate that debt. MR. HARPER, in response, stated his home is in Anchorage and he was familiar with the legislative audit. He spoke to the deficit: Right now, ... in fiscal year 04, we have a $22,000 deficit. This started back in fiscal year 98. When I was first appointed to the board, I was told that we had a revenue problem. I went back and started investigating what caused the revenue problem. I have a lot of evidence - this is not the format to - but I would be more than happy, believe me, more than happy to share it with you. We have a lot of hours that were attributable to our personnel costs, that really simply, can't be justified. I've got time sheets; I've got comparisons to the optometry board. Quite frankly, oftentimes we want to compare boards of like size. We have 107 licensed dispensing opticians - optometry is about the same number, might be 110, might be 115, but they're real close. For example in 98, the first year we noticed that there was a huge problem; our personnel costs for running our board were $17,300. Optometry's that same year were $7,300. That's a $10,000 difference. Optometry holds two meetings a year. We hold one; don't send anybody on travel; we don't eat lobster for lunch when we do meet. We're sitting here saving paperclips and staples and we couldn't figure out what was going on with all these personnel costs. Number 1485 MR. HARPER continued: Fiscal year 99, $20,500 in personnel costs compared to the Board of Optometry, which was $9,500. So, ... there's an $11,000 difference. Interestingly enough, we were told that our apprenticeship program used up a lot of hours. So I went back to find out, well, what's the breakdown. I was told that in fiscal year 99, ... the license examiner spent 168.75 hours on apprentices. In fiscal year 2000 she spent 168.75 hours on apprenticeships. Now, the chances of those two figures coming out identical one fiscal year apart, doing very different tasks, to the decimal point, uh, something's funny. I believe that this deficit ... was construed and created, not by our doing, not by the board's doing. I think the way to handle it at this point, is that what's done is done. We need to pay it off. We need to pay it off through our license renewals, which are now approaching $600 every two years, which ... on the salaries that we're talking about, is a pretty good chunk of change for a license renewal. We don't want it to go higher. If 502 is enacted, 95 percent of the division's responsibility for maintaining the statute will go away. What will happen is if, when someone wants to apply for licensure with the state of Alaska, they will send in an application that will have a checklist and it's all been done by the Department of Labor. They've got an issuance of completion of apprenticeship from the Department of Labor. They're going to have their ABO certificate, their NCLE certificate, if they're applying for a contact lense license, they're going to have all the documentation of their hours and everything and the state goes boom, boom, boom. They get a fee for doing that, so even that is not going to be part of the fiscal note as far as the ongoing maintenance of the board. That fee covers those activities. So our license renewal fee really will be going almost 100 percent paying down this deficit. Quite frankly, if everything is put in order, then we won't have the expenses that we've had. ... I was talking recently with our current license examiner, which I never cease to miss an opportunity to praise; she's just a model of efficiency. She expects to spend less than 3 percent of her time now on our board, working to maintain that license. [The gavel was passed to Vice-Chair Gatto] Number 1245 REPRESENTATIVE DAHLSTROM said to Mr. Harper, "You made a statement of 'lots of evidence of' - and then stopped yourself. Could you fill that in with one word?" She also noted he had used the phrase, "This is not the forum to discuss". MR. HARPER commented that it seemed as though they were changing license examiners every other year and as soon as they understood their job they were changed. REPRESENTATIVE DAHLSTROM repeated her question. MR. HARPER stated, "Padding the timesheet." REPRESENTATIVE DAHLSTROM asked where Mr. Harper thought the correct forum to deal with this was. MR. HARPER stated he would be happy to show her the evidence he has. He noted it would take time to go over the evidence and he agreed to present a copy to Representative Dahlstrom. REPRESENTATIVE DAHLSTROM stated he had insinuated improper actions and asked if he thought there should be an investigation conducted by someone outside the Board of Dispensing Opticians. MR. HARPER said he could not speak to an investigation. He said: I just wanted to know why and what we can do to bring that workload down so that we can afford this - whatever level of service we agree is appropriate - for this board. There were archive projects going on. There were things that we didn't ask for. And the other thing, I know that you folks have a budgeting program. Well, we have our one meeting a year for the state board that's also called our budgeting meeting. That's when we get a bill from the state that says, "This is what you spent last year. Figure out how to pay for it." Our budgeting process involves "now that you've seen what you owe, do you want to send anybody to any meetings? Is there anything special that you need or want?" And the answer is, "No, no, no, we don't want to spend any more money." So we got hit really hard during the lawsuit that was mentioned by Mr. Rozak. Many state's attorney generals got involved in it with Johnson & Johnson and the American Optometric Association supervision and so on and so forth. ... We paid an incredible amount of money to the Department of Law in 2002 and in 2003 and I can give you the exact figures where it was averaging around $2,000 a year. Contractual expenses went up to ... $9,000 and $9,300 those two years so we got clobbered again, just about the time we were starting to make headway paying down our deficit. Number 1072 REPRESENTATIVE DAHLSTROM said, "You referred to 'she' several times. Is 'she' no longer with your agency or with your organization, whoever that may be?" MR. HARPER replied that she is no longer with their organization. REPRESENTATIVE DAHLSTROM asked, "Is your understanding that 'padding time sheets' is an illegal activity? It's a yes/no." MR. HARPER replied: What I would say is that I don't know that it belongs on our board's tab. I don't know where it belongs, but I don't feel that the Board of Dispensing Opticians was where that hour entry should have been made. REPRESENTATIVE DAHLSTROM repeated her last question. MR. HARPER replied, "I don't know whether it is or not. I can't render an opinion on that." VICE CHAIR GATTO recommended that Mr. Harper make an appointment with Representative Dahlstrom to discuss this issue. [Gavel is returned to Chair Anderson] Number 1003 REPRESENTATIVE ROKEBERG asked Mr. Harper to explain to the committee why he is recommending changing the hours from 1,800 to as much as 6,000. MR. HARPER replied that in 2002 it was 6,000 hours and had been since 1973. He felt it was extraordinary when the hours were reduced to 1,800, a number that does not allow, in his opinion, time to construct an adequate apprenticeship program. He spoke about the Department of Labor's [U.S.] national guideline of, 3,000 hours for a basic optic's format. He felt this was weak because it did not address training for contact lenses or additional training in anatomy and physiology. The cumulative opinion of his board is that 6,000 hours is adequate for training in full scope opticianry. Number 0863 REPRESENTATIVE ROKEBERG requested that Mr. Harper respond to the recommendation of the audit regarding termination of the board. He also asked what the equivalent of licensure by credential would be - what the interpretation of the board is with regards to the equivalent training acceptable from another state. MR. HARPER replied that it had been the board's continuing policy to issue licensure by credential. They looked at different state's requirements which generally were 6,000 hours, or more. He pointed out that Texas, a voluntary registration state, requires four years of training for a total of 8,000 hours. REPRESENTATIVE ROKEBERG asked if the increase in hours would be an impediment to licensure for people coming into the state. MR. HARPER pointed out that it would not be, and added that in Alaska it's not required to have a licensed optician on duty. The proposed regulations address the supervision of an apprentice in the profession. He noted that the number of apprentices is 199, but he said he believes this to be very inaccurate since it included assistants. He hoped that when the apprentices reregister with the U.S. Department of Labor, the listing would be more accurate. REPRESENTATIVE ROKEBERG reiterated his question regarding termination of the Board of Dispensing Opticians. Number 0664 MR. HARPER replied that he thought this statute functioned best with a board since it created a higher responsibility for board members to manage the licensing issues. He predicted that this bill would result in many regulatory changes as a result of termination of the board. CHAIR ANDERSON announced that HB 502 would be held over in the House Labor and Commerce Standing Committee.