Kansas senators hear testimony on House Bill 2223 to expand optometrists' scope of practice

The Kansas Senate Public Health and Welfare Committee heard more than two hours of testimony on House Bill 2223, which would update the statutory scope of optometry to specify procedures optometrists may perform and to authorize the Board of Optometry to credential licensees for additional procedures.

Proponents said the bill would align state law with current optometric training and improve access to care in areas with few ophthalmologists. Todd Fleischer, executive director of the Kansas Optometric Association, said the change responds to technological and educational changes over the past decades and to students who decide not to return to Kansas because they cannot practice to the extent of their training. "Our optometrists are telling us that they're frustrated that they're not able to take care of patients the way that they're trained, educated and certified to be able to do," Fleischer said.

Dr. Shane Kanar, an optometrist practicing in southeast Kansas, told the committee optometrists already provide both refractive and medical eye care in many communities and handle postoperative and emergency care. "There is no procedure and no provider that has a 0 complication rate," Kanar said, describing collaborative relationships with ophthalmologists and the referral processes his practice uses when cases require surgical intervention.

William Wilk, senior director of government affairs for the Kansas Chamber of Commerce, framed support around workforce and access issues, saying the bill would reduce wait times and retain providers in Kansas. Dr. Nate Lighthizer, dean of the Northeastern State University Oklahoma College of Optometry, described the curriculum and proctored clinical experience at colleges of optometry and cited training and supervised clinical exposure in states that already permit the procedures included in the bill.

Opponents, including the Kansas Medical Society and the Kansas Society of Eye Surgeons and Physicians, said the measure raises patient-safety and oversight concerns. Rochelle Colombo, executive director of the Kansas Medical Society, said physicians value consistent standards for medical and surgical training and objected to allowing nonphysicians independent authority for certain surgical procedures. "We fundamentally believe patients are better served when those standards are consistent," Colombo said.

Brad Smoot, legislative counsel for the Kansas Society of Eye Surgeons and Physicians, urged the legislature to limit open-ended delegations to administrative rulemaking, noting section 1(a)(5) would allow the Board of Optometry to approve new technologies by rule. "This subsection opens the door for the board to decide just about everything new that's coming along in the future," Smoot said, and he recommended clearer statutory limits rather than leaving the details to agency rulemaking.

Susan Guile, executive director of the Kansas State Board of Healing Arts, identified the board's public-protection mission and stressed differences between physician surgical training and optometric education. "There is a vast difference in doing a procedure on a model versus a live patient," Guile told the committee.

Several conferees said the optometric association and the Kansas Medical Society had discussed an amendment to re-create an interprofessional advisory committee that would recommend new procedures to the Board of Optometry. Colombo said that amendment had been agreed in principle by the Medical Society and the optometric association and would add physician input before the board authorized new technologies by rule.

Committee members pressed proponents and opponents on training pathways and safeguards. Senators asked how Kansas optometrists would obtain proctored live-patient training if state law did not yet permit the procedures; witnesses said clinicians often seek training in neighboring states that already allow the procedures or pursue proctoring and continuing-education courses once statutory authority exists. Testimony included differing numeric claims about clinical experience: proponents described optometry curricula as including extensive coursework and clinical hours (testimony cited "over 10,000 hours" of education and "over 2,000 patient encounters" for some students) and said clinicians in other states had collectively performed tens of thousands of procedures with very few complaints to boards; opponents cautioned that complaint numbers undercount complications and urged stronger statutory limits and oversight.

The committee did not vote. Chairman Gossage told members final action would be delayed to allow review of a proposed amendment and to give members time to digest the testimony; the committee scheduled final action for the next business day at 8:30 a.m.

Background and procedural status: The bill, as described to the committee, would amend multiple Kansas statutory sections that govern optometry; the presenter said the House passed the measure by a 97–24 vote. Witnesses emphasized the measure is intended to update the practice act rather than to replace existing collaborative arrangements with ophthalmologists.

The committee hearing included questions from Senators Clifford, Thompson, Hoelscher and Penny, and testimony from optometry educators, state boards, professional associations and business groups. The committee will consider proposed amendments and take final action at the scheduled follow-up meeting.