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Optometric legislature makes progress in several states
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Optometric law has made significant headway in recent legislative sessions, both in terms of bills passed and bills blocked. In several states, strides have been made in the areas of practice scope, education and budgetary matters. According to practitioners, these positive developments can be attributed to the diligence and acumen of state optometric organizations.
Iowa expands scope
Although Iowa already boasted progressive practice scope legislation, the Iowa Optometric Association (IOA) recently decided to revisit the issue and make further changes.
“We were allowed to prescribe all classes of topical medications and oral medications by group or by class,” said Richard Noyes, OD, a member of the Iowa Optometric Assocation’s legislative committee. “This covered the majority of the agents we used, but not everything, and there are a number of good medications in the pipeline.”
Therefore, Dr. Noyes said, the IOA thought it appropriate to revisit the legislation and “correct our bill.”
“As a result of this correction, optometrists in Iowa are now permitted to use any medication available for treating the eye and the adnexa, with the exception of two orals – Imuran (azathioprine, Glaxo Wellcome) and methotrexate,” he said. “We’re allowed injectables only for anaphylaxis, but we have any route of administration per all other medications.”
The only other restriction on the bill is that ODs must inform a primary care physician if an oral steroid is prescribed for more than 14 days. “This legislation is significant because it also permits us to prescribe any future medications or future medication classes to be developed,” Dr. Noyes said. “In other words, anything in the pipeline right now is automatically approved by state code with the permission of our board of examiners.”
Opposition to the bill took the form of an initiative to create a “superboard” composed of a variety of practitioners who would decide what optometrists were permitted to do in Iowa. “But optometrists stood strong in Iowa and repudiated that effort,” Dr. Noyes told Primary Care Optometry News. “And that is very important, because it allows optometrists in Iowa to decide what the scope of optometry should be, particularly in the future. So the future of optometry in the state is looking very healthy right now.”
Dr. Noyes specifically commended the younger members of the IOA for their work on the bill. “We are particularly proud of the way our younger state leaders stepped up and handled a good majority of this battle,” he said. “Iowa’s old horses in the legislative committee were involved directly, but most of the work, the idea formation and the meetings were handled by our younger docs. We’re very proud of them.”
Two victories for Colorado
In Colorado, progress has recently been made in the areas of practice scope and continuing education, according to Rodney D. Fair, OD, FAAO, legislative chairperson of the Colorado Optometric Association (COA).
“We have a process in Colorado called Sunset, where the entire practice act is reviewed to see if it is appropriate for the state optometric board of examiners to continue its existence,” he said. “So we made an effort to reduce the onerous restrictions that we had on our practice act, which came out of our last legislative effort in 1995 — the compromises that were made with ophthalmology to get the legislation passed.”
One of these restrictions that was eliminated pertained to mandatory referral and consultation prior to initiating treatment for glaucoma patients; an additional requirement was for mandatory referral for juvenile patients with iritis who were not responding to topical steroids within a certain time frame. A third restriction eliminated by the association applied to oral and antiviral medications for treating ocular diseases of the anterior segment.
The COA also fought and successfully blocked a proposal made by the Department of Regulatory Agencies, which would do away with continuing education programs in Colorado, Dr. Fair said. “We felt that was a mistake,” he said. “We are happy to say that we got everything we wanted. We didn’t have to compromise at all.
“We have a very effective grassroots organization, and our executive director, Dr. Gwenne Hume, and the staff are outstanding,” he continued. “We work very hard at this.”
Georgia: a different ballgame
Despite the ophthalmic media’s widespread characterization of Georgia’s most recent session as a “no hitter legislative session” against optometry, officials for the Georgia Optometric Association (GOA) view things differently. “I think it is misleading to say we were defeated,” said Georgianne Bearden, GOA executive director. “We got what we wanted, but we just went about it in a different way.”
Ms. Bearden outlined one bill put forward by the GOA involving the optometry formulary in Georgia. “In this state, before an OD can prescribe a medication, it has to be on the formulary for optometrists to use,” she said. “We wanted to introduce legislation that states that once the Food and Drug Administration has approved a drug, it can be placed on the formulary within 30 days.”
Although opposition from the Georgia Society of Ophthalmology blocked the passage of this bill, Ms. Bearden said the matter has since been taken up by the state licensing board.
“The executive director of the state licensing board told us that this could be handled internally,” she told Primary Care Optometry News. “We felt that we really did accomplish what we had intended in the first place. We called attention to the problem. We believe if the we had not introduced the bill, the licensing boards wouldn’t have come forward, volunteering to make the changes needed to stop unnecessary delays in prescribing new medications.”
The GOA willingly shelved a second bill regarding the prescription of oral medications, Ms. Bearden said. “We know in an election year, we should not push such a controversial issue,” she said. “But we put the scope enhancement issue out there, and we kept the opposition busy.”
The GOA also successfully killed legislation that would have removed restrictions on Georgia’s contact lens prescription release law. “In other words, according to the proposed bill, prescriptions could be filled without a current prescription or a written prescription,” Ms. Bearden said. “We have a very good contact release law currently, so we came out against this bill. And we killed the legislation.”
The GOA also defeated a proposed budgetary change that would mean cutbacks in funding to Georgia residents wishing to attend optometry schools out of state. “We don’t have an optometry school in Georgia,” Ms. Bearden said. “The taxpayers in our state have committed to providing grants for students wishing to attend the University of Alabama-Birmingham or the Southern College of Optometry. The appropriations bill we amended had proposed that there be no money for optometry grants this year.”
The GOA managed to get this funding put back into the budget. “We felt that was significant, especially in a time where the economy has started to take a downturn,” she said. “To us, it was a good year.”
For Your Information:
- Richard Noyes, OD, is a member of the Iowa Optometric Association Legislative Committee and the Iowa Board of Optometry Examiners. He can be reached at 1065 E. Post Road, Marion, IA 52302-5214; (319) 377-2222; fax: (319) 377-2967.
- Rodney D. Fair, OD, FAAO, can be reached at 105 Bridge Street, Brighton, CO 80601; (303) 659-3036; fax: (303) 659-0053.
- Georgianne Bearden is the executive director of the Georgia Optometric Association. She can be reached at 1000 Corporate Ctr. Drive, Morrow, GA 30260; (770) 961-9866; fax: (770) 961-9965.