[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6317126,"mediaKeyId","2375013-9e2bcc5540d05c729a730631591b9400","parentId",2375013,"title","Doctors and optometrists clash in Senate hearing over expanding optometrists’ in‑office surgical authority","audioSeconds",2962,"startMs",5483000,"endMs",8445000,"viewUrl","/Search/View?dp=1&key=2375013-9e2bcc5540d05c729a730631591b9400&start=5483&end=8445","thumbnailUrl","https://assets.pipeline.soar.com/2375013-9e2bcc5540d05c729a730631591b9400/thumbnail_5483000.jpg","articleUrl","/articles/6317126/Montana/Doctors-and-optometrists-clash-in-Senate-hearing-over-expanding-optometrists-inoffice-surgical-authority","mediaUrl","https://secure.pipeline.soar.com/6317126-0985c5529866e329d2aa1e49222073c1/orig.mp4?Expires=1771206649&Signature=EIbUns2n9FweeCpBc8dMLtxu8VV0khXvVQP9nMlVh~7gmODpMVjERqLXTqD9fB~4koJc23Cv3a9UWrB002ujYsWS2-O~K3MiswOzgHLR9drkTx5M0mDzJAUyUawrr9LuPFBfBM07kQYuchcVYDr8A0w2cSKCtQpMEJGURHI9xSsoXcOvL~Qkb8PMc~K0GfJIbPPGdvjHAS6-Bg64EHh5KJiI5Z5KxfavJaFQMCMOniZm7gfDjwiXXum~XkjbXqyMCSjDJ4cOiyo1O92987rFtm9-I8JN4qGU8w6PesHAIMmO~ZWtBg6zUKrdYr6EpA9Walu6l-xlw4mC8gf1THUxRg__&Key-Pair-Id=KUT5TJCACFTXG","author","Montana Legislature","date","2025-02-21T00:00:00Z","article","Representative Ed Buttrey, speaking in the Senate Business and Labor Committee, opened a hearing on House Bill 218, which would update Montana’s optometry practice act to allow certified optometrists to perform specified in‑office surgical and laser procedures limited to the anterior segment of the eye and adnexa.

“Optometrists are trained and educated to perform these procedures and Montana law is 25 years out of date,” Buttrey told the committee. Supporters said the change would improve access to timely eye care in rural communities, reduce travel for elderly and immobile patients, and allow optometrists who have received accredited training and board certification to treat certain conditions locally.

Doctors of optometry who testified described their education and training — a four‑year optometry program after undergraduate study — and said additional certification by the Montana Board of Optometry would be required before any optometrist could perform the newly authorized procedures. Proponents stressed that the bill would not authorize refractive (vision‑correction) laser surgery, intravitreal injections, or penetrating surgeries such as cataract extraction.

“Modernizing the practice will allow patients to receive timely, high‑quality care where they live,” said Dr. Ron Benner, an optometrist from Laurel who testified in favor of the bill. Several other Montana optometrists and the Montana Optometric Association urged passage, and witnesses distributed a statewide map showing optometrist locations and argued the state’s ophthalmologist workforce is concentrated in a small number of urban centers.

Ophthalmologists, physicians and medical associations strongly opposed the measure on patient‑safety grounds. Dr. Scott Guess, an ophthalmologist, said ophthalmologists receive medical school and residency training that includes thousands of hours of supervised surgical experience and argued that legislation cannot substitute for that depth of surgical training.

“Legislation does not change the training that’s required to appropriately perform surgery,” Dr. Guess said, adding that certain procedures can lead to severe complications — including retinal tears, bleeding and in extreme cases permanent vision loss — that require specialist management.

Other opponents cited evidence from other states that expanded scopes of practice for optometrists did not meaningfully improve access and sometimes led to higher rates of retreatment or complicated outcomes. Members of the Montana Academy of Ophthalmology and the Montana Medical Association handed the committee letters and case examples from other states and highlighted the role of subspecialty training and referral networks for complicated cases.

Department of Labor and Industry staff and licensing officials provided procedural context: the Montana Board of Optometry would set certification standards and the Department administers licensure. Bureau Chief Kevin Bragg told the committee the board would undertake rulemaking and that the department would create an endorsement on a license for providers who met board‑set qualifications.

Committee members asked whether federal facilities (such as VA hospitals or military treatment facilities) would accept optometrists performing these procedures; testimony noted that federal policies vary and that some federal facilities do not permit optometrists to perform the proposed procedures on federal sites. Members also pressed for data from other states about utilization rates, retreatment frequencies and whether access actually improved in large or rural counties; several opponents said they would supply studies and case examples.

The hearing ended without a committee vote. The sponsor said he would work with stakeholders and that the board and department would need to craft certification and oversight rules if the committee moved the bill forward.","mediaType","Video","parentTitle","Senate Business, Labor, and Economic Affairs Feb 21, 2025","oneSentenceSummary","Representative Ed Buttrey introduced House Bill 218 to the Senate Business and Labor Committee, seeking to allow board‑certified optometrists in Montana to perform specified in‑office laser and anterior‑eye procedures after additional certification by the Montana Board of Optometry.","taxTitle","2025 Legislature MT, Montana","taxId",77694,"location","Montana","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6317131,"Senate committee hears bill to create Montana Family and Medical Leave Insurance; questions on cost, timing and employer impact",2106,507000,2613000,"/Search/View?dp=1&key=2375013-9e2bcc5540d05c729a730631591b9400&start=507&end=2613","https://assets.pipeline.soar.com/2375013-9e2bcc5540d05c729a730631591b9400/thumbnail_507000.jpg","/articles/6317131/Montana/Senate-committee-hears-bill-to-create-Montana-Family-and-Medical-Leave-Insurance-questions-on-cost-timing-and-employer-impact","https://secure.pipeline.soar.com/6317131-58165d5fc919367accf6ffb05f206e1b/orig.mp4?Expires=1771206649&Signature=gfZoItPLLrBfSJCCgSdi1yr-Lic0SfNrSxy7OND0VaGPMixEk2cLZVZLbthAUHBTRs0jTvSjqj2NTKLOp9cQAHgv2NsECeKwtnoaKLBpH5v~oUDFo30t27PePM64jOVotjcnEIsDZu4~M1SRaY20UzipaxjN6c2kGYpupFxXHHMxscfb~Z1mXaC8l-dbbfUoC8GT7J~VM8Yo73hCCMdIXS1pA0zOxcF7EfjzchZi3~TIas6HWK~CM6saam~Bskpw38JpbK8ZTT1RfHei1aULCs6--oUE1e0veQcSPQ39oXXzHdJcZuiiifjH4xzqWq99utdVXfOrFF-wu8r0BFjpIA__&Key-Pair-Id=KUT5TJCACFTXG","Senate Business and Labor Committee members heard testimony on Senate Bill 325, the “Montana Family and Medical Leave Insurance Act,” which would create a state‑run paid family and medical leave program funded by employer and employee contributions split equally and limited by a 1 percent cap on wages.

Supporters said the program would provide wage replacement for qualifying events — such as a serious health condition, care of a new child, or care for certain family members — and would mirror eligibility and wage calculations used in Montana’s unemployment insurance system. Proponents also emphasized a higher benefit share for low‑wage workers, an inclusive definition of family, and reduced contribution rates for very small employers.

The bill would let the Department of Labor and Industry administer a new Family Medical Leave Insurance Fund. Under Senate Bill 325, an eligible worker could take up to 480 hours (12 weeks) of paid leave in a benefit year; weekly benefit amounts would scale with income and be capped at $1,000. The sponsor and proponents told the committee the intent is that benefits run concurrently with federal FMLA when both apply.

“This bill will help keep workers attached to the workforce and allow families to care for loved ones without risking economic devastation,” said Senator Derek Harvey, the bill’s sponsor, during opening remarks. Patrick Yawaki, who testified representing several tribal communities and organizations, urged a “due pass” vote and said the bill respects tribal governments’ ability to elect participation. Other supporters included representatives from family‑support nonprofits, the Montana AFL‑CIO, Montana Nurses Association, and business advocates who said paid leave can reduce turnover and boost recruitment.

Department of Labor and Industry officials answered committee questions about start‑up and operating costs. Commissioner Sarah Swanson told the committee the department anticipates creating a new bureau to run the program and estimated five initial staffers in the start‑up year (growing to eight in 2027 and roughly 29 by 2029 if usage reaches projections). She said front‑end technology to accept contributions and process claims could cost about $14 million. The department estimates claims could number roughly 8,500 in 2027 and rise to just over 15,000 by 2030; average weekly benefits were projected in testimony at roughly $572–$642 per week and program payouts in later years in the tens of millions.

Committee members pressed several points in follow‑up: how solvency and reinsurance would be handled, whether the Legislature could later redirect fund balances, how the program would treat existing employer leave policies or paid time off, and how the new program would coordinate with collective bargaining agreements. The sponsor and Department witnesses said the bill caps contribution rates so the state is not on the hook for benefit payouts, that rulemaking would address opt‑out or coordination mechanisms, and that the Department expects contributions to be collected before benefits are paid out.

Opponents raised small‑business concerns. Rhonda Wiggers, representing the National Federation of Independent Business, said even a modest payroll contribution is effectively a tax and cautioned that small employers rely on flexible paid‑time‑off models and could be disadvantaged by a uniform contribution requirement. She also flagged practical concerns about job‑restoration obligations for very small employers who must fill critical roles.

Committee discussion also covered how the bill treats self‑employed individuals (an opt‑in provision), tribal notification requirements, proposed criminal and civil penalties for fraudulent claims, and the bill’s effective dates: collection would begin July 1, 2026, with payments to begin once the fund reached solvency.

The hearing closed without a committee vote. Senator Harvey said he would work with stakeholders on clarifications and that a fiscal note and additional details would be supplied to the committee.","Senate Business and Labor Committee members heard testimony on Senate Bill 325, the “Montana Family and Medical Leave Insurance Act,” which would create a state‑run paid family and medical leave program funded by employer and employee contributions split equally and limited by a 1 percent cap on wages.","actionData","errors"]

Article not found

Doctors and optometrists clash in Senate hearing over expanding optometrists’ in‑office surgical authority

Senate committee hears bill to create Montana Family and Medical Leave Insurance; questions on cost, timing and employer impact