SB 55-OPTOMETRY & OPTOMETRISTS  2:42:01 PM CHAIR COSTELLO announced the consideration of SB 55. She noted this is the second hearing and the intent is to continue public testimony. 2:42:55 PM DR. MIKE BENNETT, OD, Alaska Optometric Association (AOA), testified in support of SB 55. He provided his education and work history. He said there have been a lot of fairy tales about what the bill would do and they are not accurate. He countered the notion that the AOA board would authorize untrained procedures should the bill pass. He pointed out that self- regulating boards have a long history of success and their primary charge is to protect the public. There is no hidden agenda. 2:45:46 PM BOB PALMER, State Affairs Policy Director, American Academy of Ophthalmology, testified in opposition to SB 55. He focused on policy issues, especially the language in the bill regarding surgery, which leaves open what is acceptable. He believes optometrists would be able to perform several hundred additional surgical procedures, which is unacceptable. He suggested defining what constitutes surgery and then back out what should not be included. He discussed how other states have addressed this issue. He concluded that defining surgery protects the patient. 2:50:27 PM SENATOR GIESSEL asked where he is from. MR. PALMER said Washington D.C. SENATOR GIESSEL asked if his organization paid for movie, radio, and TV ads, robocalls, and mailings. MR. PALMER said no. They gave the Alaska Society of Eye Physicians and Surgeons a grant of about $50,000. CHAIR COSTELLO asked him to provide the specific information to the committee. 2:51:55 PM PAUL MARKS, representing himself, testified in opposition to SB 55. He shared a personal experience with optometrists and said he doesn't support an optometrist doing surgery when he isn't qualified to do so. SENATOR GIESSEL asked if an optometrist did surgery on his eye. MR. MARKS answered no; he went to Anchorage. SENATOR GIESSEL restated that the optometrist did not perform surgery. 2:55:53 PM DR. GRIFFITH STEINER, MD, testified in opposition to SB 55. He provided his professional education and practice as an eye surgeon. He described this bill as specifically designed to expand the scope of practice for optometrists. It allows for injections around the eye and the right to do laser surgery. He maintained that they will not have enough training to do those procedures. SENATOR GIESSEL asked if the State Medical Board has a list of surgeries that he can perform. DR. STEINER said no, because physicians have medical training. SENATOR GIESSEL emphasized that the bill does not contain a list that defines what the Board of Medicine can authorize. She asked if his authorization is based on his education, which is determined by the board. DR. STEINER said yes; however, a medical board is different than an optometry board, because the medical board represents people that are trained in medicine and surgery, with many more years of training. SENATOR GIESSEL said optometrists are not asking for an expansion of practice. DR. STEINER disagreed. 2:59:55 PM MICHEAL GUZMAN, representing himself, testified in opposition to SB 55. He offered his understanding that the bill would allow an optometrist to perform eye surgery and prescribe narcotics and he does not support that. SENATOR GIESSEL asked who told him those things. MR. GUZMAN said he read it online and heard it on the radio. He said he also researched the bill. SENATOR GIESSEL asked if he is aware that optometrists have been allowed to prescribe narcotics for nine years. MR. GUZMAN said he wasn't aware of that. He asked if they can prescribe to the same degree. SENATOR GIESSEL said it may help if he was aware that many of the courses optometrists take are taught by the same instructors as ophthalmologists and they both obtain the same DEA authorization. 3:02:41 PM MATTHEW GLYNN, representing himself, testified in opposition to SB 55. He shared his story of wanting laser surgery and only finding he wasn't a candidate when he visited an ophthalmologist. SENATOR GIESSEL asked if any of the optometrists performed surgery. MR. GLYNN answered no. 3:04:36 PM TIM SMITH, representing himself, testified in opposition to SB 55. He spoke as a medical professional who was not in favor of cross training in different modalities for licensure. 3:05:38 PM EDDY IVIZARY, representing himself, testified in opposition to SB 55. He said that he feels that only a qualified surgeon should be able to operate on eyes. He shared his personal story. SENATOR GIESSEL asked who told him that optometrists would be doing eye surgery. MR. IVIZARY restated his personal story and the importance of being able to see. SENATOR GIESSEL asked if an optometrist had ever done surgery or put a needle in his eye. MR. IVIZARY said yes and he told him to stop. 3:08:28 PM DR. MICHAEL BRENNAN, Ophthalmologist, Alaska Ophthalmology Society, testified in opposition to SB 55. He shared his professional background. He maintained that the bill endangers the health of the citizens of Alaska. The bill has two inherent flaws; the brevity in the education and training required to manage complex medical and surgical conditions, and second, the vague language regarding penetrative surgery. He also addressed the over-prescribing of potent pharmaceuticals. SENATOR GIESSEL asked how much money the society has invested in ads opposing the bill. DR. BRENNAN said the organization invests in a wide variety of advocacy activities in order to provide patient safety. He said he has not made a direct contribution to those ads. He did not know how much the organization spent. SENATOR GIESSEL asked if he is aware that optometry has been prescribing controlled substances for nine years. DR. BRENNAN said they don't for for schedule IA and schedule IIA drugs. He said the bill expands the pharmaceutical array. SENATOR GIESSEL said the bill doesn't say that. 3:15:28 PM At ease 3:16:08 PM CHAIR COSTELLO reconvened the meeting. 3:16:49 PM LUCRETIA ANN DEMIS, representing herself, testified in opposition to SB 55. She doesn't think that optometrists should be authorized to do the same surgical procedures as an ophthalmologist. She said they don't have enough training or background. SENATOR GIESSEL pointed out that an optometrist refers people when they need surgery. 3:20:29 PM DR. ALFRED DERAMUS, Ophthalmologist, testified in opposition to SB 55. He shared his professional background. He said the legislation is poorly written and will not gather consensus on either side of the issue because of its content. Some of the language such as "invasive surgery" and "injections" are inflammatory and don't adequately address what is and is not surgical. 3:23:25 PM PAUL BARNEY, Chair, Alaska Board of Optometry Examiners, testified in support of SB 55. He said his primary concern is the safety of the public. In his four years on the board there have not been complaints that rose to the level of an investigation. In general, optometrists are conservative and cautious providers. The bill will not allow the board to write regulations outside of optometrists' training. He mentioned the board has oversight by the attorney general, the same as other healthcare providers. They have no intention of lifting the four-day limit on prescribing narcotics. SB 55 would modernized the definition of optometry and reflect what is currently taught in schools of optometry. 3:27:21 PM DR. DAVID ZUMBRO, Ophthalmologist, testified in opposition to SB 55. He said his primary issue with SB 55 is that it attempts to define invasive surgery. As written, the definition is incomplete and wide open to interpretation. He suggested that be changed. SENATOR GIESSEL asked if he has had optometrists do surgery and had the patient referred to him afterwards. DR. ZUMBRO said no. 3:29:12 PM DR. ROBERT ARNOLD, representing himself, testified in opposition to SB 55. He said, as a pediatric ophthalmologist, he performs two complex procedures that are not described in the bill. His concern is that the definition of surgery is loose and may be open to interpretation. He noted oversight of safety for surgery in Alaska occurs via licensure and hospital privilege surgical review. SENATOR GIESSEL asked if he's had problems with optometrists performing rash interventions. DR. ARNOLD said he has not experienced surgical care by optometrists, but he has experienced excellent care by them. His partners have been optometrists. He said his concern is, as an educator, that surgical oversight is not afforded to optometrists. 3:32:09 PM STEVE DOBSON, President, Alaska Optometric Association, testified in support of SB 55. He shared his professional background. He said Alaskans have benefitted tremendously from the increase in access to quality medical optometric eye care due to past legislation. The goal of the association is to ensure the best practice of care and to attract the best graduates from the colleges of optometry. SB 55 is not about allowing eye surgery, but rather about board autonomy. To date the board has demonstrated superb confidence, integrity, and professionalism protecting the interest of the public and passage of the bill would allow continuation of that. CHAIR COSTELLO closed public testimony and held SB 55 in committee.