SB 270-BOARD OF DISPENSING OPTICIANS  CHAIRMAN STEVENS announced SB 270 to be up for consideration. MS. HEATHER BRAKES, Staff to Senator Therriault, sponsor of SB 270, said that there was a committee substitute. SENATOR AUSTERMAN moved to adopt the CS to SB 270. There were no objections and it was so ordered. MS. BRAKES said that SB 270 was based on an audit conducted by the Legislative Audit Division and it had several concerns about the Board of Dispensing Opticians. One of them was addressed in recommendation #1 on page 7 of the audit. The auditors felt the disparity between the number of people who become licensed and the number of people registering to be apprentices suggests that 6,000 hours of required apprenticeship may be unduly prohibiting people from being licensed. The auditor suggested that the board reconsider the necessity of the 6,000 requirement. The board's response agrees with the auditor's recommendation, but they want to add an additional $800 correspondence course. The course is not included in the legislation. The feeling is that it would be a hardship to the employee and the expense may be shifted to the employer. Recommendation #2 addresses the board's state exam. The 95 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 auditor suggests that the board give serious consideration to discontinuing the practical exam and require applicants only to pass the nationally recognized exams offered. Those national exams are incorporated in SB 270. The auditor continues to be concerned about the apparent subjectivity and error- prone nature of the exam. MS. BRAKES said the section 1 extends the Board of Dispensing Opticians for three years to June 30, 2005 as recommended by the audit report released on January 24. Sections 2,3,4,6,8 and 9 remove the board's state examination. Section 5 reduces the number of apprenticeship hours to 3,000 hours. It also allows for an applicant who has earned an associate degree from a recognized school or college of dispensing opticians to use it as a substituted in lieu of any apprenticeship hours. TAPE 02-5, SIDE B  MS. PAT DAVIDSON, Legislative Auditor, said that she recommended only a three-year extension until 2005 rather than the typical four-year extension. Her reasoning is discussed in the Auditor's Comments where they looked at alternative methods to achieve the purpose of the program. This looked like one where making those changes - moving to a national exam, reducing the apprenticeship hours - could be handled by the Division of Occupational Licensing under the registration process rather than full licensing under a board process. They wanted to see how the board dealt with the recommendations in the report and come back in three years and see if it appeared to still be a good idea to take it to a registration process. SENATOR AUSTERMAN asked how many states have boards. MS. DAVIDSON replied she thought 22 states currently license dispensing opticians. The other states either have a registration process or no registration or licensing. In looking at those, scope of practice seemed to be one of the key things. In other states, these type of activities may have required supervision by either an optometrist or an ophthalmologist. In this state having a license for dispensing optician allows them to establish a practice without supervision of either of those two other professions. SENATOR TORGERSON asked if the bill covered her concerns as shown in the audit. MS. DAVIDSON replied that it does. SENATOR AUSTERMAN asked if the legislature was supposed to discuss about whether they need the licensing board or not in 2005. MS. DAVIDSON replied that there are automatic sunset audits for these boards. They would come back in three years and the focus of the audit at that time would be an evaluation of whether a licensing board is still required or whether it can simply go to a registration process. SENATOR AUSTERMAN asked if the number of states having a licensing board was increasing. He wanted to know what the trend was. MS. DAVIDSON said she didn't have that information. There is a national professional organization with a website which is where they can get that kind of information. She reiterated that, "Part of the interplay with this profession has to do with those other professions that are closely associated with this type of practice. Those being the opticians and the ophthalmologists." CHAIRMAN STEVENS asked if the substitution of an associate degree was acceptable for the auditors in place of the actual hours training. MS. DAVIDSON said currently if a person has no more education beyond high school, 6,000 hours of apprenticeship is required. That is reduced to 2,000 hours if one has an associate degree. The recommendation says if you're only relying on your experience for qualification to reduce the hours from 6,000 to 3,000; but if you have a degree, your apprenticeship is waived. SENATOR TORGERSON pointed out that it is odd to say one of the qualifications is to have attended a high school for four years. He thought they would want a person to have graduated. MS. DAVIDSON responded that was an excellent point. 2:35 p.m. MR. LARRY HARPER, a dispensing optician, said he represented the State Board of Dispensing Opticians, National Contact Lens Examiners and the Opticians Association of Alaska. He noted that he had just received their working draft. He said: One of the reasons that the audit was so damning to us in regards to the testing procedures was when we look back at our past fail rate, and that's important not only here in the state, but on a national basis, we're finding that people who are coming to take this exam at the end of their 6,000 hours are doing a miserable job of passing this national written exam. The reason for asking for the home study course was to put in an educational component. The way this course works is two fold. It really develops and cleans up the apprenticeship program, of which the guidelines have been incredibly lax, and puts the apprentice himself in contact with a sponsor in the Lower 48 who is also in touch with their sponsor on the job. So they learn in an sequential manner. This program has been trouble shot over the past 20 years and reducing the hours from 6,000 to 3,000 makes no sense. If we can't bring these people to the test table and have them prepared at the end of 6,000 hours, how are we possibly going to do it in 3,000 if we don't clean up the training program: It's imperative that the training program be included in this scenario in order to prepare these people for success. MR. HARPER said the Board has found a source for a professionally written practical examination. His experience on the National Contact Lens Examiners Board and the Board of Optitionery shows that the national written test was never designed as a stand- alone competency exam for optitionery. It is an entry level certification exam so someone entering the field has an idea of what it's all about. He concluded that the educational component was necessary if the hours were reduced to 3,000. The other concerns of the legislative audit are being aggressively pursued, he said. SENATOR TORGESRON asked if he was in favor of dropping the hours to 3,000. MR. HARPER replied that he is not in favor of it unless the educational component becomes a part of the equation. "We just are not seeing the success at the testing table that we should be seeing." SENATOR TORGERSON asked if the education component was on-the-job training. MR. HARPER replied, "As with all on-the-job training, it depends greatly on the instructor as to how successful the trainee is going to be…." SENATOR AUSTERMAN said he has some concerns with exempting employees that isn't dealt with in the bill. MS. CATHERINE REARDON, Director, Division of Occupational Licensing, said her division staffs both the Board of Dispensing Opticians and the Optometry Board. She said that there are ophthalmologists who are MD physicians who specialize in eye care; then there's optometrists and opticians. In the past, there has been a difference in perspective between the Board of Dispensing Opticians and the Optometry Board over whether the employees of optometrists who do dispensing optician work should have to be licensed as dispensing opticians or optician apprentices. This came up at the time of the last extensions for both boards four or six years ago. It has been an issue of contention for longer than that. My summary is I have the impression that some optometrists have raised this issue in the last day or so - expressing the desire to have their employees exempted from the dispensing optician statute. My brief summary of what I think the arguments on either side are is that the optometrists feel like since they are supervising their employees work that they can provide the necessary public health and safety protection insuring that their employees are doing adequate dispensing optician work. So they don't need to be licensed. Mr. Harper is here, so he could correct me, but my impression is that the Dispensing Opticians Board has felt that it is necessary to have demonstrated the skills and knowledge of dispensing optitionery, which are proven through the licensing process in order to safely provide those skills to the public. CHAIRMAN STEVENS asked how long is a typically dispensing optician apprenticeship before they decide to sit for a license. MS. REARDON replied that some of the apprentices choose never to sit for the exam. They come to the end of the six years and move on to a different occupation. A dispensing optician apprentice is not highly paid; so some people are not going into those jobs as a career. They are apprentices for training. CHAIRMAN STEVENS calculated that it would take a little over three years to hit 6,000 (5,076) hours given a 240 day working year at eight hours a day; 2,000 hours would be less than one year. So he thought it would take a little less than one and a half years to meet the 3,000-hour obligation. He asked Mr. Harper why they wanted to require the home school course when it seems like the individuals would get a lot more hands-on instruction with the 3,000 hours under a professional instead of an instructor. He didn't understand the justification, because the person in the apprenticeship gets a lot more instruction. MR. HARPER replied that in almost every situation when someone is in an apprenticeship program, they are doing other things throughout the course of an 8-hour day that doesn't fall anywhere close to the realm of training. That is why time for the educational component is so important. An AA degree has the work component within it, because they all have dispensaries within the schools. Plus they are getting 8 hours of instruction without interruptions for doing other unassociated things. A degree program is much more intensive course work and covers a broader curriculum than the apprenticeship program. CHAIRMAN STEVENS asked if he was speaking for the Board or individually. He asked what the Board's position was on removing the state requirement for examination. He replied that he is speaking individually. The Board is not interested at all in removing the state requirement for examination. "That's coming from Budget and Audit. The State Board's position as reflected in the minutes of our last meeting are very very specific." CHAIRMAN STEVENS said that the correspondence curriculum would be geared towards a national test not for a state test. MR. HARPER replied that wasn't correct. He said the program they found is as good as anyone could find in a home study program. It goes far beyond the national competency exam, which is not for licensing. CHAIRMAN STEVENS asked if the National Board of Opticians has national standards. MR. HARPER said he is a past president of the Opticians Association of America and that there is a lot of different components to what they do, but how to apply that on the day-to- day work station and deliver the best in optics to the public is what the second component focuses on. We want these people prepared for success and we want the very best for the population for the State of Alaska. This is a very good public health program and we need more of them. This doesn't cost the state a dime…" CHAIRMAN STEVENS asked how many people begin as apprentices actually sit for a license. MS. REARDON replied eight. MR. HARPER said they have reviewed the results and are not happy with them. "There has been a 10-year lapse and we feel that this board has a lot of work to do." MS. DAVIDSON said on page 13 of the Audit Report they identify the number of apprenticeships by fiscal year for the last three years as well as the number of licenses issued for dispensing opticians. You'll see a significant difference in those numbers. I would add that it does appear, just given those numbers, that as Ms. Reardon spoke to, not everyone working for a dispensing optician has the goal of that as their profession in mind. When there's a discussion about apprentices taking that course, the concern becomes is it reasonable for people who are not looking for licensure as a dispensing optician to go through that expense. If you are trying to raise your passage rate and it's a good idea, then it's a good idea. I don't know that the state wants to create that type of requirement. If they are not prepared to pass that national test, then they won't. Our concern with the audit is the problems with the practical exam. It was a problem six years ago and it's a continuing problem. Being a problem when you're dealing with a licensing function is that you're putting barriers of entry into the profession in front of individuals and that's what we see as the major problem and those have to go away. I understand the Board may want to set those standards high enough to protect the public, but they cannot be as subjective as they are right now, because it causes more problems. CHAIRMAN STEVENS asked if a prior audit had the same recommendations. MS. DAVIDSON replied that their prior audit six years ago also identified problems with the practical exam given by the Board in terms of its error-prone nature and its lack of real objective criteria. MR. HARPER said he couldn't agree with Ms. Davidson more. "The strange truth of the matter is that opticians are not necessarily qualified to be professional test writers. Therefore, they did an RFP and have found a good test and would like to give it in April. There is no cost to the state; there's no increased cost to the test takers. All it does is give them a professionally qualified exam…. Both the chairman and I have taken the exam. It is absolutely straight-forward. There is no guess work; there is no subjectivity - just yes or no. There's only one answer. CHAIRMAN STEVENS asked if he had a position on exempting certain employees from statute. MR. HARPER replied that has been an on-going topic of discussion. The position of the Optician's Board is this, "If you are going to make independent optician decisions having to do with patient care, then you need to be a licensed dispensing optician or working under someone's direct supervision." If someone wants to be a frame stylist or whatever, they don't have a problem with that. He said that there are a few optometrists who don't like the fact that their people have to be trained. SENATOR TORGERSON noted a letter from the Board to Ms. Davidson in which they approve the 3,000 hours and moved to pass CSSB 270 (L&C) from committee with individual recommendations and the accompanying fiscal note. There were no objections and it was so ordered.