Bills in Missouri threaten comanagement for ODs

Issue: May 2001

JEFFERSON CITY, Mo. – Bills that would severely restrict comanagement opportunities for optometrists in Missouri have been filed in the House of Representatives as well as the Senate here and are currently under review. On March 14, a hearing was held on both pieces of legislation – the House in the morning, and the Senate in the afternoon.

Some MD support for optometry

House Bill 785 and Senate Bill 552, both of which were filed in February, were drafted by the Missouri Surgeons and Eye Physicians Society (MOSEPS). While the original bill prevented most optometrists from comanaging, both a House committee substitute and a Senate committee substitute containing information that the Missouri Optometric Association (MOA) had negotiated was presented at the hearing. The MOA, who testified in opposition in both hearings, was joined in its opposition by ophthalmologists who testified for the MOA, said Zoe Lyle, executive director for the MOA. A coalition of ophthalmologists also wrote letters and e-mails opposing the bill, said Ms. Lyle.

“No vote was taken in committee; by my observation, if they had voted, it looked like it would have been a pretty close vote in the House,” she said. “In the Senate, I think we had a slight edge, but that would be difficult [to determine.]”

MOA President Lee Ann Barrett, OD, said that in the state of Missouri, an amendment could be made to a bill that is directly related and already in the House or Senate, which is what may happen in this case. “The way the legislature works and the way bills go, it’s too late to pass this as a clean, stand-alone bill, so we’re watching to see if it gets amended onto any other piece of legislation,” she said. “Right now the MOA board feels that comanagement rules and guidelines should be handled as a rule and a regulation with our governing boards as opposed to a statute. That is why the board voted to not agree to the amended language that was presented at the committee, because we feel strongly that this belongs in rule.”

Geography the issue

Passage of the bills would restrict comanagement for optometrists in terms of geographical distance, said Ms. Lyle. “Many optometrists choose a surgeon based on skill level,” she said. “The bills make that nearly impossible. They require that if a surgeon is available, that surgeon must provide the comanagement. So it would really hamper the optometric profession.”

The legislative session ends May 18, Ms. Lyle said, and at press time, no vote had been taken in the committee and nothing had been debated on the floor. “We’re remaining over-vigilant,” she told Primary Care Optometry News. “We checked with the state board of optometry and the board of healing arts, and there have been no complaints filed by either board, so I think that’s very interesting. There are allegations that abuse exists in the system, but there are no documented incidents. If any anecdotal stories need to be addressed, we believe that should be done by rule of each of the respective boards.”

While the bill seems to have come out of nowhere, said Ms. Lyle, there may be a reason for Missouri being targeted. “There is a bill in Florida that is moving rather quickly,” she said. “Optometry is relatively strong in these states – we think, politically, Missouri and Florida have good reputations, and we think that’s why ophthalmology chose these states. If they’re successful here, I think you’ll see a trend across the nation.”

For Your Information:

Zoe Lyle is the executive director of the Missouri Optometric Association. She may be reached at 100 East High St., Ste. 301, Jefferson City, MO 65101-2960; (573) 635-6151; fax: (573) 635-7989; e-mail: MOOPT@socket.net.

Lee Ann Barrett, OD, is the president of the MOA. She may be reached at 2101 West Broadway, Columbia, MO 65203; (573) 445-8636; fax: (573) 446-9122.