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Committee reviews S.64 to create advanced therapeutic specialty for optometrists
Summary
A legislative committee heard extensive testimony on S.64, a bill to create an advanced therapeutic procedure specialty for optometrists that would expand the procedures some optometrists may perform, set education and preceptorship requirements, require national exams and adverse-event reporting, and take effect Jan. 1, 2027 if enacted.
Thursday, Feb. 20 — The Science Committee of Government Operations held an informational hearing on S.64, an act to amend the scope of practice for optometrists to allow a narrowly defined set of additional procedures under a new “advanced therapeutic procedure specialty.”
The bill would add a specialty designation permitting certain optometrists to perform a limited list of surgical and laser procedures to the front of the eye, specified injections and removal of small noncancerous lesions, subject to education, supervised clinical preceptorship, passage of national examinations and reporting requirements. Sen. Reca White, sponsor of the measure, said the expansion is intended to improve access to care for communities near the Vermont–New Hampshire border and elsewhere in the state.
Supporters told the committee the change would increase access to lower-cost, office-based care and free ophthalmologists to focus on more complex surgical cases. Optometrist Dr. Dean Barcelo described the procedures now proposed as “chairside,” short in duration and low risk when performed by credentialed practitioners. He said many of the procedures covered in the bill are taught in optometry education and are already performed in other states.
Key provisions discussed include: a definition of an advanced therapeutic procedure specialty; a 32-hour prescribed didactic course for optometrists who graduated before 2019 (graduates from 2019 onward would not be required to take that additional course because that content is now part of standard optometry training); an 8-hour minimum supervised clinical preceptorship with in-person supervision on live human patients; national written and clinical examinations administered by the National Board of Examiners in Optometry (including injection and laser/surgical procedure components); a requirement that preceptors have at least three years’ experience performing those procedures; five additional continuing education hours on advanced procedures every two-year licensure period for specialty holders; and adverse-event reporting to the Office of Professional Regulation (OPR) within 30 days.
The bill preserves a long list of prohibited practices for optometrists, including LASIK, procedures requiring general anesthesia, and intraocular injections except where the bill expressly allows them for specific advanced procedures. The draft would also permit a narrow opioid prescribing exception: hydrocodone in combination with an analgesic for no more than a 72-hour supply with no refills.
OPR’s deputy secretary, Lauren Hibbert, told the committee that OPR initially did not recommend expansion in 2019 but, after receiving additional materials and state comparisons, now supports a scoped expansion provided the bill’s education, preceptorship and national-examination safeguards remain. Hibbert said OPR recommended retaining the national examinations as a core verification tool and supported the post-degree preceptorship requirement, noting OPR had considered but did not adopt a 100-hour preceptorship recommendation after stakeholders argued it would be excessive.
Committee members questioned workforce and access impacts, with senators asking whether the state has enough optometrists to use the new authority and whether the changes would speed patients’ access to needed care. Dr. Barcelo said 12 states have comparable full expansions and about 14 others allow some procedures; he described potential improvements in access, workforce recruitment and lower out-of-pocket costs for patients who otherwise travel to hospital systems for the same procedures.
No formal committee vote on S.64 was recorded at the hearing. Sponsors and witnesses said the bill’s effective date is Jan. 1, 2027 to give the board time to implement rules and processes.
The hearing record includes a technical report OPR produced in 2023 and referenced comparative state reports and the educational syllabi used to craft the bill’s training requirements. Committee members requested additional materials and signaled they would continue deliberations in subsequent meetings.
Ending: The committee moved on to other business after extended testimony and questioning. Proponents said S.64 seeks incremental, safety-focused expansion of office-based procedures for optometrists; OPR emphasized national exams, preceptorship verification and adverse-event reporting as the bill’s key safety mechanisms.
