HB 245-LICENSING FOR OPTOMETRY  3:27:08 PM CHAIR OLSON announced that the first order of business would be HOUSE BILL NO. 245, "An Act relating to licensure as an optometrist; establishing a retired status optometrist license; and providing for an effective date." 3:27:20 PM KACI SCHROEDER HOTCH, Staff, Representative Bill Thomas, Jr., Alaska State Legislature, on behalf of the prime sponsor, Representative Bill Thomas, paraphrased the sponsor statement, which read [original punctuation provided]: HB 245 makes some necessary changes to the licensure criteria for optometrists in this state. Currently, Alaska has three levels of licensure for optometrists: 1.) Basic License (no pharmaceuticals) 2.) License with Pharmaceutical Endorsement (in-office eye drops) 3.) License with Pharmaceutical Prescription and Use Endorsement (prescribing authority). The Board of Optometry would like to have a standard level of care that everyone receives from optometrists. Therefore, some adjustments need to be made in statute to require the highest level of care. HB 245 brings Alaska statutes in line with current educational levels. Students graduating from optometry schools within the last five years have already received the level of education necessary to obtain a license at the highest level currently provided in Alaska. Further, most licensed optometrists in Alaska have already obtained the level of education necessary for the highest level of licensure. There are only a handful of people who have not received that education and most of these optometrists are nearing retirement age. These optometrists would be issued a restricted license which would allow them to continue to practice but still not allow them to provide services that go beyond their level of education. The level of education required in HB 245 has been standard in most optometrist schools across the country and older optometrists have already obtained this level of education on their own. Many states are currently working on or have already passed similar legislation. Our citizens deserve the most current and highest level of care possible; allowing the licensure of optometrists with less than the standard education levels puts our citizens at risk. HB 245 remedies this problem by standardizing the licensure requirements for optometrists in Alaska. 3:28:29 PM MS. SCHROEDER HOTCH presented a section-by-section analysis of HB 245. Section 1 outlines the education requirements required for licensure, including that the applicant must pass written exam, and complete course work on ocular diseases, pharmaceutical agent injections, or other course work outlined by the board. Section 2 would allow an applicant to retake the exam if he/she previously failed the exam. Section 3 would require applicants for licensure by credential to possess a license from a state that has licensure requirement equivalent to Alaska, to pass the Alaska state exam, as well as the National Board of Examiners of Optometry's exam. 3:29:27 PM MS. SCHROEDER HOTCH explained that Section 4 relates to renewal of licenses, including that licensees must meet the minimum number of continuing education, consisting of 8 hours related to prescription of pharmaceutical agents and 7 hours related to injection of non-topical therapeutic pharmaceutical agents, and meet other requirements outlined by the board through regulations. Section 5 would establish the status of retired license, which does not need to be renewed, and can be reactivated upon application and upon meeting continuing education requirements. 3:30:04 PM MS. SCHROEDER HOTCH explained that Section 6 and 7 would remove references to certain classes of licenses that are being eliminated. Section 8 would provide transition for a person who is not currently licensed at the highest level of optometry licensure to continue to practice until he/she has met the additional education requirements. Section 10 would establish an immediate effective date. 3:30:34 PM REPRESENTATIVE BUCH referred to Section 3, and inquired as to whether this would require applicants to pass a national exam. MS. SCHROEDER HOTCH answered yes. REPRESENTATIVE BUCH asked whether the board referred to in the bill is the state board. MS. SCHROEDER HOTCH answered yes. The board referred to in HB 245 is the State Board of Examiners in Optometry. 3:31:25 PM REPRESENTATIVE BUCH referred to Section 8, to the grandfather clause and asked for clarification. MS. SCHROEDER HOTCH referred to page 5 of the bill. She explained that an optometrist who did not wish to upgrade his/her license could opt for a restricted license. 3:32:17 PM CHAIR OLSON asked for an estimate of the number of optometrists who would be grandfathered in and would not choose to upgrade their licenses. MS. SCHROEDER HOTCH anticipated that 25 people would be affected by this section of the bill. 3:32:37 PM REPRESENTATIVE LYNN asked for clarification on the term "injectables." He recalled his own personal eye surgery and an injection he received. MS. SCHROEDER HOTCH deferred to Ms. Geering to discuss injections. 3:33:10 PM REPRESENTATIVE T. WILSON referred to page 2, line 23 of HB 245, noting that an applicant could retake a portion of test, but that the bill would require applicants to retake the entire examination. MS. SCHROEDER HOTCH deferred to Ms. Geering to answer the question. JILL GEERING, Optometrist; Chair, Board of Examiners in Optometry, explained that injections, such as the one Representative Lynn described, would rarely be used. She remarked that the reason to leave the language in the bill is to allow for expansion of the technology and techniques, emphasizing that the current use of injections is limited. 3:35:00 PM REPRESENTATIVE LYNN asked about injections performed for routine cataract and laser surgeries. DR. GEERING advised that those types of procedures would be performed by an opthalmologist. The optometrists are not asking to expand their practice to include surgery or other procedures. 3:35:36 PM REPRESENTATIVE NEUMAN asked for the definitions of optometrist and opthamologist. DR. GEERING explained that an opthamologist attends medical school and completes a residency in opthamology and is also a medical doctor (MD). An optometrist attends a four-year optometrist's program in an Optometry school, with an optional one year of residency, resulting in a Doctor of Optometry, or OD designation. The primary difference between an opthamologist and an optometrist in Alaska is that only an opthamologist can perform surgery. The differences vary from state to state since optometrists are licensed by each state. In Alaska, optometrists are allowed to prescribe topical drops, oral medications, treat glaucoma, and perform superficial injections. 3:36:57 PM REPRESENTATIVE NEUMAN related his understanding that HB 245 would affect an optometrist, but not an opthamologist. DR. GEERING agreed. REPRESENTATIVE NEUMAN referred to page 2, line 31, of HB 245, and asked which schools are recognized by board. DR. GEERING related that the Alaska Board of Examiners for Optometry currently places a list of approved schools into its regulations. She clarified that the board recognizes 13 or 14 Optometry schools in the U.S. and Canada. The Alaska Board of Examiners in Optometry does not recognize programs from other countries since the programs are not accredited for optometric education in the U.S. 3:38:40 PM REPRESENTATIVE NEUMAN asked whether the board has ever denied anyone licensure. DR. GEERING did not recall anyone ever being denied in the six years that she has served on the board. In further response to Representative Neuman, she recalled that all of the applications she has reviewed have been for candidates who graduated from a U.S. school, which possess more stringent programs than the programs in most foreign countries. 3:39:42 PM REPRESENTATIVE T. WILSON asked for the reason that applicants retaking the exam would have to take the entire text instead of a portion of the exam. DR. GEERING explained that previously the Board of Examiners in Optometry administered its own test, but now the board accepts the national examination so this technically cleans up the language to reflect that applicants take the national exam. 3:40:30 PM REPRESENTATIVE BUCH referred to the zero fiscal note attached to the bill. He asked whether board members would be compensated for attending board meetings. DR. GEERING responded that the Board of Examiners in Optometry (BEO) is comprised of four optometrists and one public member. The BEO meets two times a year, once face-to-face, and once by teleconference. She said the BEO may actually result in a negative fiscal note since under HB 245 the level of licenses changes. Currently, applicants can apply for one of three levels of licensing, with each level having different requirements for licensure. She remarked that this can be confusing to applicants. Thus, the DCCED's staff must spend considerable time with applicants and in issuing the endorsements for each level of license. However, the number of times the board will meet will not change. 3:43:24 PM CHAIR OLSON, after first determining no one else wished to testify, closed public testimony on HB 245. 3:43:28 PM REPRESENTATIVE NEUMAN moved to report HB 245 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HB 245 was reported from the House Labor and Commerce Standing Committee. 3:43:58 PM The committee took an at-ease from 3:43 p.m. to 3:46 p.m.