CS FOR SENATE BILL NO. 255(L&C) "An Act extending the termination date for the Board of Examiners in Optometry; amending the licensing endorsement and renewal provisions for optometrists; and providing for an effective date." This was the first hearing for this bill in the Senate Finance Committee. TOM MAHER, Staff to Senator Gene Therriault, read the sponsor statement into the record as follows. This legislation stems from recommendations contained in the Legislative Audit Report entitled, "Department of Commerce, Community and Economic Development, Board of Examiners in Optometry Sunset Audit", dated September 27, 2005 [copy on file.] Legislative Audit concluded that the Board of Examiners in Optometry (BEO) continues to serve a public need and is operating in the public best interest. The regulation and licensing of qualified optometrists is necessary to protect the public's health, safety and welfare. Further, the BEO has operated effectively, adopted regulatory changes and supported legislation that improved its oversight process and promoted more effective regulation of licensed optometrists. Accordingly, SB 255 extends the sunset date for the BEO to June 30, 2014 for an eight-year extension. Legislative Audit also recommended that the Legislature amend the optometry statutes to ensure they support current license endorsement for the diagnostic use of pharmaceutical agents. Currently, statutory language provides for a single endorsement for both prescribe and use. However, the BEO is issuing two types of endorsements. The first allows a practitioner to both prescribe and use pharmaceutical agents and the second type of endorsements allows a practitioner "use" only. Current law does not authorize the use only endorsement. SB 255 corrects this situation by adding a section authorizing a use only endorsement and also "grandfathers" in the practitioners that were given that endorsement over the years. Finally, the Senate Labor and Commerce Committee approved an amendment offered by the Department of Commerce, Community and Economic Development that deleted the statutory cite requiring 24 hours of continuing education instruction, allowing the Board to establish through regulation, the number of hours without amending statute. This amendment was requested by the BEO in its response to the audit. Mr. Maher stated that the operational expenses of this Board would not change as a result of the changes made. 9:29:14 AM Senator Olson asked if additional witnesses were present to testify to this bill. 9:29:24 AM Vice Chair Bunde answered that no others had signed up to testify. 9:29:27 AM Senator Olson asked about the endorsements allowing optometrists to use pharmaceuticals but not prescribe them. 9:30:03 AM Mr. Maher replied that this proposed change would correct a situation already occurring in which the Board issues such endorsements. 9:30:15 AM PAT DAVIDSON, Director, Division of Legislative Audit, recalled that during the early 1990s, statutes were changed to allow optometrists to use and prescribe pharmaceutical agents. However, the legal interpretation of this provision stipulated that the optometrist must practice both use and prescription. The proposed change would provide an endorsement for optometrists intending to only use pharmaceuticals and not prescribe them. 9:31:26 AM Senator Olson asked if optometrists have commented on the use and prescription of pharmaceuticals. 9:31:41 AM Ms. Davidson told of extensive discussion on the matter during the 1990s when the statute was originally amended to allow the practice. The issue before the Committee in this legislation pertains to endorsement for use only. Ms. Davidson explained that the career span of most practicing optometrists is approximately 30 years. Education of optometry has only included instruction on the dispensing of prescriptions for the past ten to 15 years. Some practitioners do not feel adequately trained to prescribe medications. 9:32:59 AM Senator Olson asked if the endorsement is limited to topical medication or includes systemic medications. 9:33:24 AM Ms. Davidson had not researched the matter for this hearing, as the provision is already law. 9:33:48 AM Senator Dyson shared that he had learned that the endorsement only extends to topical pharmaceuticals. 9:33:59 AM Senator Dyson asked the purpose of the addition of the provision pertaining to postgraduate continuing education in Section 4 of the committee substitute. 9:34:37 AM Mr. Maher responded that the Senate Labor and Commerce adopted the change at the request of the Board. 9:34:47 AM Ms. Davidson furthered that the intent is to eliminate the statutorily determined number of hours of continuing education required. This provision would direct the Board to determine the appropriate number of hours through the regulatory process. 9:35:33 AM RICK URION, Director, Division of Corporations, Business and Professional Licensing, Department of Commerce, Community, and Economic Development, requested additional changes to be made to the bill. He did not propose these amendments when the Senate Labor and Commerce Committee was hearing the bill because some legislators "came to the erroneous opinion" that sunset legislation should only address the extension of lapse dates and should propose no changes to the conditions of the entity being audited. He disagreed with this position, asserting that the scheduled lapse extensions were an opportunity to implement necessary changes. Once the term of an entity was extended no further attention was paid to matters pertaining to that entity. AT EASE 9:37:18 AM 9:37:49 AM Amendment #1: This amendment deletes "president" and inserts "chair" in subsection (c)(1) of AS 08.72.060. Miscellaneous powers and duties of board. The amended statute reads as follows. (c) The board shall (1) elect a chair [PRESIDENT] and secretary from among its members… This amendment also inserts new subparagraphs to AS 08.72.140. Qualifications for examination., which stipulates the conditions an applicant must meet to take the examination. The inserted language reads as follows. (3) has not committed an act in any jurisdiction that would have constituted a violation of this chapter or regulation adopted under this chapter at the time the act was committed; and  (4) has not been disciplined by an optometry licensing entity in another jurisdiction and is not the subject of a pending disciplinary proceeding conducted by an optometry licensing entity in another jurisdiction; however, the board may consider the disciplinary action and in its discretion determine if the person is qualified to be admitted to the examination. This amendment also inserts language to subparagraph (8) of AS 08.72.170. Licensure by credentials., which stipulates the conditions an applicant must meet to receive a license by credentials. The amended language reads as follows. (8) has not been disciplined by an optometry licensing entity in another jurisdiction and is not the subject of a pending disciplinary proceeding conducted by an optometry licensing entity in another jurisdiction; however, the board may consider the disciplinary action and in its discretion determine if the person is qualified for licensure. This amendment also deletes subparagraph (6) of AS 08.72.181. Fees., pertaining to the fees the Department would set. The deleted language reads as follows. [(6) BRANCH OFFICE LICENSE AND RENEWAL] This amendment also deletes AS 08.72.274. Exemption., from statute. The deleted language reads as follows. [AS 08.72.274. EXEMPTION. EXCEPT FOR AS 08.72.275, THIS CHAPTER AND REGULATIONS ADOPTED UNDER THIS CHAPTER DO NOT LIMIT THE PRACTICE OF AN OPTICIAN LICENSED UNDER AS 08.71.] New Text Underlined [DELETED TEXT BRACKETED] Senator Dyson moved for adoption. Vice Chair Bunde objected for an explanation. Mr. Urion stated that the Board requested the changes proposed in this amendment during the audit process. The proposed changes were endorsed by the "audit process" but were not included in the Division of Legislative Audit recommendations. Mr. Urion characterized the changes as housekeeping amendments that would allow the board to "better license people and get people to work" and would provide discretion to the board in determining whether to license applicants by their credentials or by examination. Mr. Urion noted the change of title of the board leadership position from "president" to "chair" would be consistent with other law in which the governor could appoint a person to the seat. Mr. Urion stated that the Division no longer licenses branch offices and therefore the setting of a fee for this service is not applicable. 9:39:29 AM Senator Olson asserted that the proposed statutory change pertaining to board discretion regarding disciplinary actions taken in other jurisdictions would be significant. He asked the historical position of the board in dealing with disciplinary actions against an optometrist. 9:39:58 AM Mr. Urion read a statement made by the president of the board, "Currently there is nothing in the practice act authorizing the board to deny or put stipulations on new licenses by examination." Mr. Urion explained that the board currently has no such discretion, which the adoption of this amendment would allow. 9:40:25 AM Senator Olson asked the purpose of the board if almost every applicant would be guaranteed a license. 9:40:41 AM Mr. Urion corrected that not every applicant would receive a license. The proposal would provide discretion to the board to make determinations. The disciplinary action taken in another jurisdiction could have been for an offense not identified as such in Alaska statute, or the offence could have occurred several years prior, or been a minor offense. 9:41:01 AM Senator Olson asked the number of optometrists disciplined during Mr. Urion's tenure with the Division. 9:41:18 AM Mr. Urion answered, "Not very many if any." 9:41:23 AM Senator Dyson appreciated the presentation of the amendment. He declared a potential conflict of interest in that his personal optician is the current president of the board, is politically active in local affairs and Senator Dyson has contributed to his campaigns. 9:42:12 AM Senator Olson asked about the deletion of certain fees. 9:42:20 AM Mr. Urion reiterated that only the fees pertaining to the branch office would only be eliminated. 9:42:54 AM Ms. Davidson had reviewed the amendment and noted that although most of the changes appear to be "housekeeping", she was unsure about the consequences of repealing AS 08.72.274. Exemption., from statute. This statute provides exemptions "except for AS 08.72.275". The referenced statute, AS 08.72.275 applies to both opticians and optometrists and provides an exemption to the standard specification of eyewear that a licensee could dispense, including nonflammable and plastic coated lenses. Eyewear that did not meet the standard specification could be dispensed at the written request of the patient under this statute. Ms. Davidson was unsure whether the repeal of AS 08.72.274 would eliminate this exemption for some practitioners. She was unaware of current practice in this matter. 9:45:38 AM Vice Chair Bunde stated that additional time could be spent to address these concerns or the amendment could be amended to remove the proposed repeal of AS 08.72.274. 9:45:50 AM Mr. Urion preferred the latter. 9:46:04 AM Senator Stedman offered a motion to amend the amendment to delete the language that would repeal AS 08.72.274. There was no objection and the amendment was AMENDED. 9:46:19 AM Without further objection Amendment #1 as amended was ADOPTED. 9:46:26 AM Senator Dyson offered to sponsor an amendment to repeal the statute when the full Senate body considered this bill if the determination was made that the repeal would have no unintended consequences. 9:47:20 AM Senator Stedman offered a motion to report CS SB 255(L&C), as amended, from Committee with individual recommendations and accompanying fiscal note. There was no objection and CS SB 255 (FIN) was MOVED from Committee with zero fiscal note #1 from the Department of Commerce, Community and Economic Development.