House passed legislation to expand the scope of practice of optometrists

On Tuesday, the Alabama House of Representatives passed legislation that would expand local optometrists’ services.

House Bill 349 (HB349) is sponsored by State Representative Danny Garrett.

“1995 was the last time we expanded our optometry law in terms of scope of practice,” Garrett said. “A lot of things have changed since 1995. Nobody had smartphones then?”

Garrett said that many things have also changed in optometry over the last 28 years.

“What this bill does is very strictly limited,” Garrett said. “It allows optometrists to perform three procedures they are already trained to do.”

Followers of the Alabama Legislature know that optometrists and ophthalmologists have been fighting for decades over the scope of practice that the state of Alabama will allow trained optometrists to do.

“I have been carrying this legislation for seven years,” Garrett said.

Garrett explained that this was also about giving citizens access to healthcare as 57 counties have an optometrist practicing there, but only 23 counties have an ophthalmologist.

“This is a turf thing,” for the ophthalmologists Garrett said. “We haven’t seen an increase in ophthalmologists in Alabama. I have never seen a plan to expand ophthalmology in Alabama.”

Garret explained that this legislation would not allow optometrists to make injections in the eyeball or perform eye surgeries.

Rep. Mark Shirey is an optometrist.

“We have to be trained under an ophthalmologist,” Shirey said. “The vaccines were suggested by the ophthalmologists.”

Rep. Thomas Jackson said, “I have to drive 102 miles to see an ophthalmologist even though we have several optometrists who practice in Thomasville and Clarke County.”

House Minority Leader Anthony Daniels said, “I have been here ten years dealing with the scope of practice, and I have not seen any expansion of access to ophthalmologists.”

“When you compare this with other states, this is actually the most restrictive bill to expand the scope of practice, and they are still not satisfied,” Daniels said. “We have groups out there who are opposed to things just to be opposed to it.”

“I have heard more from the opposition than I have heard in the last eight months,” Daniels continued. “There are always going to be fear tactics used. This is just how some of these folks operate.”

“If you are not going to recruit more specialists to the state of Alabama, then these are the things that we are going to look at to provide access,” Daniels said. “I think it is a great piece of legislation. It is more restrictive than what I expected, but it is a start.”

Daniels said that the procedures, including corrective lasers, are fairly simple.

“I might be able to do that, not that I am seeking to expand the scope of practice to myself,” Daniels said, “The insurance companies that provide the malpractice insurance are not coming out against this. That they are not opposing this legislation makes me wonder what is the real issue here.”

“The optometrists will tell you that there are six or seven procedures that ought to be on here,” Garrett said. “This would just allow optometrists to do what they are trained to do it, albeit on a very restricted basis.”

Rep. Barry Forte said, “I represent District 84. I represent a lot of poor folks. I have one constituent; she is over 70 years old, and she has to go all the way to Dothan to get this procedure on her eyes. She is 50 miles from Dothan. She has to pay somebody to drive her all the way to Dothan to get this procedure. She lives only half a mile from the doctor’s (optometrist) office. This is the best bill I have ever seen.”

Rep. Danny Crawford explained that he had to go out of state for an eye procedure because his optometrist wasn’t allowed to treat the problem. Crawford said, “It (the procedure) took ten minutes. I had to go out of state.”

Rep. A.J. McCampbell said, “You may not be able to see if you wait for five or six weeks, as Rep. Crawford said. I have people who struggle to go to the grocery store. It takes my people an hour drive to get medical procedures done that they need.”

The House passed HB349 83 to 6. The legislation now goes to the Senate for their consideration.

Thursday will be day 20 of the 2023 Alabama Regular Legislative Session.

To connect with the author of this story or to comment, email brandonmreporter@gmail.com.