ALASKA STATE LEGISLATURE  SENATE LABOR AND COMMERCE STANDING COMMITTEE  March 29, 2016 1:32 p.m.   MEMBERS PRESENT Senator Mia Costello, Chair Senator Cathy Giessel, Vice Chair Senator Kevin Meyer Senator Gary Stevens Senator Johnny Ellis MEMBERS ABSENT  All members present COMMITTEE CALENDAR  CONFIRMATION HEARINGS Alaska Gasline Development Corporation Board of Directors DAVID CRUZ - Palmer, Alaska LUKE THOMAS HOPKINS - Fairbanks, Alaska - HEARD AND HELD SENATE BILL NO. 206 "An Act relating to a reinsurance program for residents who are high risks and insurer assessments to cover the costs of the reinsurance program; relating to application for state innovation waivers for health care insurance; relating to definitions of 'residents who are high risks' and 'covered lives'; and providing for an effective date." - HEARD & HELD SENATE BILL NO. 55 "An Act relating to the practice of optometry." - HEARD & HELD PREVIOUS COMMITTEE ACTION  BILL: SB 206 SHORT TITLE: REINSURANCE PROGRAM; HEALTH INS. WAIVERS SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR 03/25/16 (S) READ THE FIRST TIME - REFERRALS 03/25/16 (S) L&C, FIN 03/29/16 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg) BILL: SB 55 SHORT TITLE: OPTOMETRY & OPTOMETRISTS SPONSOR(s): GIESSEL BY REQUEST 02/18/15 (S) READ THE FIRST TIME - REFERRALS 02/18/15 (S) HSS, L&C 03/18/15 (S) HSS AT 1:30 PM BUTROVICH 205 03/18/15 (S) Heard & Held 03/18/15 (S) MINUTE (HSS) 02/01/16 (S) HSS AT 1:30 PM BUTROVICH 205 02/01/16 (S) Moved SB 55 Out of Committee 02/01/16 (S) MINUTE (HSS) 02/08/16 (S) HSS RPT 3DP 1NR 02/08/16 (S) DP: STEDMAN, STOLTZE, GIESSEL 02/08/16 (S) NR: ELLIS 03/10/16 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg) 03/10/16 (S) Heard & Held 03/10/16 (S) MINUTE (L&C) 03/29/16 (S) L&C AT 1:30 PM BELTZ 105 (TSBldg) WITNESS REGISTER    DAVID CRUZ, Appointee Alaska Gasline Development Corporation Board of Directors Palmer, Alaska POSITION STATEMENT: Testified as appointee to the Alaska Gasline Development Corporation Board of Directors. LUKE THOMAS HOPKINS, Appointee Alaska Gasline Development Corporation Board of Directors Fairbanks, Alaska POSITION STATEMENT: Testified as appointee to the Alaska Gasline Development Corporation Board of Directors. LORI WING-HEIER Director Division of Insurance Department of Commerce, Community and Economic Development Anchorage, Alaska POSITION STATEMENT: Discussed the two parts of SB 206. SHEELA TALLMAN, Legislative Policy Manager Premera Blue Cross Blue Shield of Alaska Seattle, Washington POSITION STATEMENT: Testified in support of SB 206. ALBERT FOGLE Alaska Association of Health Underwriters Anchorage, Alaska POSITION STATEMENT: Testified in support of SB 206. KRAIG ANDERSON, Senior Vice President and Actuary Moda Health Portland, Oregon POSITION STATEMENT: Testified in support of SB 206. MIKE BENNETT, OD Alaska Optometric Association Juneau, Alaska POSITION STATEMENT: Testified in support of SB 55. BOB PALMER, State Affairs Policy Director American Academy of Ophthalmology Washington, D.C. POSITION STATEMENT: Testified in opposition to SB 55. PAUL MARKS, representing himself POSITION STATEMENT: Testified in opposition to SB 55. GRIFFITH STEINER, MD, representing himself Anchorage, Alaska POSITION STATEMENT: Testified in opposition to SB 55. MICHEAL GUZMAN, representing himself Anchorage, Alaska POSITION STATEMENT: Testified in opposition to SB 55. MATTHEW GLYNN, representing himself Anchorage, Alaska POSITION STATEMENT: Testified in opposition to SB 55. TIM SMITH, representing himself Anchorage, Alaska POSITION STATEMENT: Testified in opposition to SB 55. EDDY IVIZARY, representing himself Anchorage, Alaska POSITION STATEMENT: Testified in opposition to SB 55. MICHAEL BRENNAN, MD - Ophthalmologist Alaska Ophthalmology Society North Carolina POSITION STATEMENT: Testified in opposition to SB 55. LUCRETIA ANN DEMIS, representing herself Anchorage, Alaska POSITION STATEMENT: Testified in opposition to SB 55. ALFRED DERAMUS, MD - Ophthalmologist representing himself Fairbanks, Alaska POSITION STATEMENT: Testified in opposition to SB 55. PAUL BARNEY, Chair Alaska Board of Optometry Examiners POSITION STATEMENT: Testified in support of SB 55. DAVID ZUMBRO, MD - Ophthalmologist representing himself Anchorage, Alaska POSITION STATEMENT: Testified in opposition to SB 55. ROBERT ARNOLD, Ophthalmologist representing himself Anchorage, Alaska POSITION STATEMENT: Testified in opposition to SB 55. STEVE DOBSON, President Alaska Optometric Association Anchorage, Alaska POSITION STATEMENT: Testified in support of SB 55. ACTION NARRATIVE  1:32:43 PM CHAIR MIA COSTELLO called the Senate Labor and Commerce Standing Committee meeting to order at 1:32 p.m. Present at the call to order were Senators Giessel, Ellis, Stevens, and Chair Costello. ^Confirmation Hearings Confirmation Hearings  Alaska Gasline Development Corporation Board of Directors 1:33:51 PM CHAIR COSTELLO announced the first order of business would be confirmation hearings of governor appointments to the Alaska Gasline Development Corporation Board of Directors. 1:33:50 PM At ease 1:35:27 PM CHAIR COSTELLO reconvened the hearing and asked Mr. Cruz to tell the committee his interest in continuing to serve on the Alaska Gasline Development Corporation (AGDC) Board of Directors. 1:36:17 PM DAVID CRUZ, Appointee, Alaska Gasline Development Corporation (AGDC) Board of Directors, said he has been on the AGDC Board since its inception. He is engaged in the industry on a daily basis and he owns and operates several companies involved with pipeline construction. He has served on the board in a number of capacities and is willing to continue to serve. He believes the projects are essential for Alaska going forward. CHAIR COSTELLO asked how progress currently is going with AKLNG. MR. CRUZ said the project is going well and good working relationships with the producers continues. All participants are willing to help the project move forward. His overall experience is that this is a large endeavor to make either project successful and economic. It is important that Alaska is an equal partner with the producers CHAIR COSTELLO asked what he sees as the largest challenge and how the board can facilitate it. MR. CRUZ said it is advantageous that the state is an equal partner to facilitate the project. Getting three producers together and working on the terms is the tough part; the technical side is the easy part. 1:40:57 PM SENATOR GIESSEL asked if he has signed a confidentiality agreement. MR. CRUZ said yes. SENATOR GIESSEL asked how many have signed such agreements. MR. CRUZ said he's the only one. SENATOR GIESSEL asked if the previous chair has a role with AGDC. MR. CRUZ replied he is general counsel. SENATOR GIESSEL asked how the search for a president is going. MR. CRUZ said it's going well and the board is interviewing the top two candidates. The legislature will have a say prior to the hire. 1:42:51 PM SENATOR STEVENS asked when gas will flow. MR. CRUZ said the target has always been 2025. Both projects have had steady progress and AGDC will hold the permits this year, which is monumental. The rights-of-way permits can be handed over to AKLNG to facilitate the project. 1:44:38 PM CHAIR COSTELLO asked if the board has any concerns about the progress of the AKLNG project or current state policies regarding it. MR. CRUZ said no; AGDC is well engaged with the state gasline team and has good working relationships with all the entities. CHAIR COSTELLO asked if the board has a diverse enough membership to tackle this project. MR. CRUZ said yes; the board works well together. SENATOR GIESSEL asked if he feels the board has the right qualifications. MR. CRUZ said he does at this point. 1:47:56 PM SENATOR MEYER joined the committee. SENATOR GIESSEL noted he is distinguishing between the current board and the previous board. MR. CRUZ said that's correct. Today's requirements differ from those of previous boards. CHAIR COSTELLO thanked Mr. Cruz for his dedication to the state. She noted that she will forward all the names in one batch. 1:50:40 PM At ease 1:51:08 PM CHAIR COSTELLO reconvened the meeting and asked Mr. Hopkins to tell the committee his interest in serving on the Alaska Gasline Development Corporation Board of Directors. 1:51:47 PM LUKE THOMAS HOPKINS, Appointee, Alaska Gasline Development Corporation Board of Directors, reviewed his personal and professional history in Alaska. Most recently he has been involved with organizing and moving forward on building a new gas utility in Fairbanks. He is pleased to be part of the AGDC board and chair of the Communications Committee and a member of the Governance Committee. CHAIR COSTELLO asked what he is doing to ensure the success of AKLNG. MR. HOPKINS mentioned approving actions on receiving funding for the buyout of TransCanada that included acquiring all of TransCanada's data. Also, he helped with the work plan and budget to get to a decisional point. CHAIR COSTELLO asked if his role is reactive or proactive. MR. HOPKINS said he sees his role as proactive. He discussed the board meetings and interactions to keep on a timeline. CHAIR COSTELLO asked if he had signed a confidentiality agreement. MR. HOPKINS said he has never been presented with a document to sign, but is aware of the process and procedure. CHAIR COSTELLO asked if he would sign one if presented. MR. HOPKINS said he'd need to read it before signing, but he has no problem with confidentiality. 2:00:47 PM SENATOR MEYER asked who the legal counsel is for AGDC. MR. HOPKINS said it's John Burns. SENATOR MEYER asked if Mr. Burns was a previous board member. MR. HOPKINS answered yes; he was on the board until mid- November. SENATOR MEYER asked Mr. Hopkins for examples of his gas pipeline experience. MR. HOPKINS mentioned working with the Alaska Gasline Port Authority projects as a board member from 2006 to 2010. He said he also worked on the AGIA project as one of the options for the APP project. He expanded on his work with the buildout of the Fairbanks Gas Authority. He also worked on the size of transmission lines for the Fairbanks municipal utility. SENATOR MEYER asked if he supports having two legislative members on the AGDC board. MR. HOPKINS said what's important is that everyone works together and communication is open. SENATOR MEYER said he hopes he understands the legislature's frustration being asked to appropriate money when they aren't part of the executive discussion. 2:07:44 PM MR. HOPKINS said having the two funds already appropriated is important to people outside of the board, such as producers. He voiced appreciation for legislative funding. SENATOR GIESSEL asked what undergraduate degree he received at the University of Alaska - Fairbanks. MR. HOPKINS said he doesn't have a degree, just four years' work starting in wildlife management and ending in physical anthropology. From there he started a small manufacturing business. CHAIR COSTELLO thanked Mr. Hopkins for coming before the committee. 2:10:15 PM At ease SB 206-REINSURANCE PROGRAM; HEALTH INS. WAIVERS  2:11:18 PM CHAIR COSTELLO reconvened the meeting and announced the consideration of SB 206. 2:12:00 PM LORI WING-HEIER Director, Division of Insurance, Department of Commerce, Community and Economic Development (DCCED), discussed the two parts of SB 206. The bill is designed to allow the director of insurance to establish a reinsurance program to address the high-cost claims that were once part, or considered part, of the Alaska Comprehensive Health Insurance Association (ACHIA). This was prior to the Affordable Care Act (ACA) being implemented. The bill expressly establishes a reinsurance pool for high-risk claims to go into ACHIA and be reinsured through ACHIA - Chapter 55 of Title 21. It will operate much like the Children's Reinsurance Pool of 2013. MS. WING-HEIER continued to say that SB 206 also says that the 50 percent tax credit would no longer be allowed for this particular insurance program. The other part of the bill allows the director of insurance to apply to the Centers for Medicare and Medicaid (CMS) for an innovation waiver. This is a Section 1332 waiver to provide insurance under ACA in individual, small group, and, potentially, the large group markets in Alaska. Enabling legislation is required to begin the process. She provided background on why this is needed. She stressed the high cost of the individual market in Alaska which has seen a 40 percent increase in the past two years from Premera and Moda. Early indications are that rate increases will be more than 25 percent. In addition, the risk assessment and the risk corridor will sunset in 2016 under the federal program. Reinsurance alone paid over $19 million to Premera and $13 million to Moda. Those costs need to be reabsorbed somehow. She provided examples of the 40 percent rate increases to consumers. In 2014, a 45-year-old was paying about $486 a month for a gold plan; the same membership in 2017 will be about $1,300 a month. 2:16:36 PM CHAIR COSTELLO asked if the federal reinsurance program expires or sunsets. MS. WING-HEIER said it expires at the end of 2016. ACHIA will replace it in some way. It won't reduce rates, but will provide stability. Provider losses are substantial and the rates must be adequate. CHAIR COSTELLO asked her to explain the higher-risk medical conditions. MS. WING-HEIER said they would take the most costly conditions out of the individual market and spread them out to ACHIA. It will be a reinsurance pool. 2:19:09 PM SENATOR ELLIS asked, should this legislation pass, will it be a negotiation point, or will the state just hope that private insurers don't increase rates as much as 25 percent. He asked what the terms of negotiation might be. MS. WING-HEIER said she could not make commitments regarding rates, but the state will always negotiate and the rates will still not be enough to cover all the claims in the pool. There is a lot of uncertainty in the markets. SENATOR ELLIS commented that he doesn't know what the state is getting for this kind of cost, even though he understands the administration's need to take action to protect consumers. MS. WING-HEIER explained if the state continues on the current path, the rates will likely increase and the individual market will go into a death spiral. The intent of the ACA was for people to be able to afford insurance. Alaska is faced with incredibly high costs for health care resulting in high costs for insurance. The idea is to spread the top 10 percent of high- cost claims over the reinsurance pool. She pointed out that the state could also consider the Chapter 1332 waiver for a long-term solution. The reinsurance plan is an immediate answer. SENATOR ELLIS said "or a portion thereof." CHAIR COSTELLO said her understanding is this bill would make the rate increase less egregious. MS. WING-HEIER said that's correct. CHAIR COSTELLO offered her understanding that the second part of the bill provides a longer-term solution. She asked if the division would return to the legislature in order to pursue the waiver. MS. WING-HEIER said yes. 2:23:18 PM CHAIR COSTELLO opened public testimony. 2:23:30 PM SHEELA TALLMAN, Legislative Policy Manager, Premera Blue Cross Blue Shield of Alaska, testified in support of SB 206. She provided the history of Premera in Alaska since 1952 and its coverage. She commented on the changes in the market that are impacting Premera's individual plan premiums. She noted that Premera has experienced a number of new high-cost enrollees after the health reform in 2014. In 2014, Premera had losses of about $13 million in the individual market and sought rate increases of almost 40 percent for 2015 and 2016 to account for the high risk individuals. Premera is taking in, on average, $713 per member per month in premium and paying out $913 per member per month. There aren't enough ratepayers to offset the high costs, nor are the subsidies some receive. MS. TALLMAN stated that Premera supports the reinsurance program and the innovation waiver. The program helps address premium increases, but also helps provide some stability to the market and may attract new competitors. 2:29:27 PM SENATOR ELLIS asked about the timeframe on the waiver going forward. MS. TALLMAN said the states can begin applying for the waiver in 2017. SENATOR ELLIS asked what other states have a similar issue of rising healthcare costs and setting up a reinsurance approach. MS. TALLMAN said Oregon has addressed the matter and other states will follow. SENATOR ELLIS asked if Premera will commit to an amount of a less-than-40-percent increase in premiums if this legislation passes. MS. TALLMAN said she can't make a specific commitment regarding rates, but would be committed to working on rule making for a balanced assessment across the market. 2:32:57 PM SENATOR ELLIS said the state is being asked in a relatively short timeframe to take an affirmative action. He is willing to entertain the request, but would like insurance companies to commit as well and form a partnership. CHAIR COSTELLO said she appreciates the remarks and is aware of the situation that it brings. MS. TALLMAN said Premera is committed to working with the division on the actual program that would be implemented via the rule making and has been doing so for the last year. There is a lot of uncertainty now regarding the market. 2:35:16 PM ALBERT FOGLE, Alaska Association of Health Underwriters, testified in support of SB 206. He described the bill as a tool to help with the survival of the individual marketplace. It will help stabilize the market and smooth out premiums for individuals and families going forward. It isn't the fault of the carriers, but the geography of Alaska and its unique market. He highlighted that ACA limits premiums a health insurance carrier can charge. They are allowed just 20 percent for administrative costs. 2:38:27 PM KRAIG ANDERSON, Senior Vice President and Actuary, Moda Health, testified in support of SB 206. He described Moda's business in Alaska since 2007. Moda offers policies both on and off the exchanges and is one of two providers. They are committed to policyholders in Alaska. He echoed comments made by Ms. Tallman regarding the market and how the bill would help. He noted they have submitted detailed claims data to model the impact of the ACHIA program. CHAIR COSTELLO closed public testimony and held SB 206 in committee. 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. 3:36:06 PM There being no further business to come before the committee, Chair Costello adjourned the Senate Labor and Commerce Standing Committee meeting at 3:36 p.m.