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Battle continues in three states without glaucoma privileges
Currently, optometrists in only three states remain without glaucoma prescribing privileges, in spite of ongoing efforts to advance legislation there.
Primary Care Optometry News recently revisited this issue with representatives from these three states — Vermont, Massachusetts and Hawaii — all of whom continue to be optimistic that this legislation is forthcoming.
“These bills will be passed,” said Tim Johnson, OD, legislative chair for the Vermont Optometric Association. “At this point, we don’t know when, but they will be passed.”
Vermont: bills “still alive”
Vermont’s most recent activity on the legislative front was the introduction of twin bills SB 54 and HB 273, according to Dr. Johnson. The bills are a therapeutic pharmaceutical agent amplification to allow any medication appropriate to primary eye care, he said.
According to an Aug. 1, 2003, press release disseminated by the American Academy of Ophthalmology, these bills “were defeated in the 2003 Vermont State Legislature, which has adjourned.” The alleged suppression of this legislation was attributed to efforts by the American Academy of Ophthalmology, the Vermont Ophthalmological Society and the Vermont Medical Society.
The press release went on to state that the bills “would have allowed optometrists to prescribe controlled substances, injections and would have allowed them to have independent glaucoma privileges.”
According to Dr. Johnson, however, the twin bills have not yet received any formal legislative activity, let alone been voted on or defeated.
“These are not dead bills,” he said. “The legislature meets from January until May or so. It is a biennium, so all of the bills that were not acted on the first year are carried over into the second year.”
Dr. Johnson said the bills essentially would enable optometrists to treat glaucoma and prescribe certain oral medications that are appropriate to treat eye disease.
He said he didn’t understand the American Academy of Ophthalmology’s assertion that they successfully prevented a “Pandora’s box of new optometric privileges that could have threatened the current quality of eye care in Vermont,” according to the press release.
“That’s not exactly true,” he said. “The VOA and its members continue to work very hard to pass this legislation.”
Massachusetts: planning to persist
As one of the last states to gain therapeutic privileges, Massachusetts is accustomed to long legislative fights.
Last fall, the Massachusetts Society of Optometrists (MSO) filed an enhancement of the scope of practice. This scope of practice bill would allow optometrists to treat glaucoma and to prescribe oral medications to treat eye diseases and adnexa. The bill would also permit the application of epinephrine, adrenaline and other agents used in the percutaneous treatment of anaphylaxis.
Due in part to strong opposition from physicians, the MSO has been unsuccessful in passing the legislation. But according to Richard Lawless, executive director of the MSO, the bill will be revisited in the near future.
“We are still active in this session; it is a 2-year session,” Mr. Lawless said. “The bill is in the health care committee at the present time. The house and senate have a joint health care committee. We are hoping to see some action once the legislature is back in session.”
Hawaii: improving patient care
In Hawaii, glaucoma legislation has been repeatedly added onto TPA bills, according to James Fujisaki, OD, president of the Hawaii Optometric Association (HOA). “We have always added it to our TPA bills, but it has always been taken out,” he said. “We needed to take it out for the bills to move on.”
Dr. Fujisaki said Hawaii’s next legislative session begins in January and that the HOA is contemplating its next move. “At this stage, we are discussing it,” he said. “We will be meeting with our key legislators and getting some feedback from them.”
Although the HOA has not actively pursued glaucoma legislation recently, Dr. Fujisaki maintains that the issue continues to be very important in Hawaii. “We have been kind of quiet lately, but it is important,” he said. “It will enhance our profession and improve our patient care.”
For Your Information:
- Tim Johnson, OD, can be reached at PO Box 517, 231 Rockingham Rd., Bellows Falls, VT 05101; (802) 463-4216; fax: (802) 463-2543.
- Richard Lawless can be reached at 1071 Worcester Rd., Framingham, MA 01701-5298; (508) 875-7900; fax: (508) 875-0010.
- James Fujisaki, OD, can be reached at 94-824 Moloalo St., Waipaha, HI 96797; phone/fax: (808) 677-0734.