Senate committee reviews S.64 to let optometrists perform specified advanced procedures

The Senate Government Operations Committee discussed S.64, a bill that would expand the scope of practice for optometrists in Vermont by authorizing an advanced therapeutic-procedures specialty for licensees who meet new education, training and competency requirements.

The committee’s discussion, led by the bill’s sponsor and staff, described the Office of Professional Regulation’s (OPR) 2023 report recommending a specialty endorsement and noted that OPR “stands by the recommendations made in the 02/2023 report,” while the Board of Medical Practice raised concerns about patient outcomes.

OPR staff testified that the 2023 study, following an earlier 2020 sunrise review, concluded specified surgical, laser and injection procedures could be performed safely if optometrists complete the listed qualifications: a Vermont optometry license, a postgraduate residency or equivalent postgraduate training, a preceptorship, and passage of two examinations administered by the National Board of Examiners in Optometry. Jennifer Collin, general counsel for OPR, told the committee OPR supports the bill language and noted the agency would need to establish rulemaking, IT and outreach infrastructure to implement the endorsement if S.64 becomes law. “OPR does support the language of this bill,” Collin said during testimony.

Representatives of the Board of Medical Practice, including its physician representative, expressed continuing objections. Dr. Hildebrand, speaking for the Board of Medical Practice, said the board previously voted against expansion and remains concerned the available evidence does not show improved access or reduced costs, and that optometrists’ surgical training differs substantially from ophthalmologists’. “Our assessment is this is a solution without a problem,” Dr. Hildebrand said, summarizing the board’s concerns about patient outcomes and limited evidence of access benefits.

Supporters and advocates told the committee that the bill would improve access to eye care and reduce patient travel and referral delays. Committee testimony noted that optometrists complete a lengthy educational path (described in testimony as eight years of education and postgraduate training with at least 2,000 patient encounters) and that 12 states already allow a similar expanded scope, while parts of the requested procedures are permitted in another 14 states. The committee also heard that the bill would require reporting of adverse events and biennial reporting of outcomes to OPR to ensure monitoring and safety.

Committee members and witnesses emphasized that only optometrists who hold the specialty endorsement could perform the advanced procedures and that the proposed Vermont requirements aim to be among the most stringent in states that allow scope expansion. No committee vote on S.64 was taken at this meeting; the item was set aside to return later with further testimony, including additional presentations from the Office of Professional Regulation and the Board of Medical Practice.

Background: The committee record shows OPR issued an initial sunrise review in February 2019 and a more detailed report in February 2023; the 2023 report is the basis for OPR’s present recommendation to authorize an advanced therapeutic-procedures specialty for optometrists.

The committee indicated it will invite additional witnesses back for fuller testimony before acting further on S.64.