Kansas committee hears testimony on bill to expand optometrists' scope to include certain laser and eyelid procedures

The House Committee on Health and Human Services heard more than three hours of proponent and opponent testimony on House Bill 2,223, a bill that would amend Kansas optometry law to add specified procedures to the practice of optometry and require credentialing by the Board of Optometry. Committee staff said the bill, if passed, would take effect July 1, 2025 after publication in the statute book.

Supporters said the bill would modernize the Optometric Practice Act, expand access to care in rural communities and let optometrists perform procedures they are trained to do. Todd Plesser, executive director of the Kansas Optometric Association, said the measure “modernizes the Optometric Practice Act to reflect contemporary optometric education and training.” He and other proponents said delays in accessing ophthalmologists force patients, often older or with limited transportation, to travel out of town for care.

Proponents also pointed to training and outcomes from other states. Dr. Shane Kennar, an optometrist practicing in southeast Kansas, said graduates since 2017 receive training in the bill’s procedures and that optometrists pursue continuing education to learn techniques they did not receive in earlier years. Dr. Nate Lighthizer, dean of the NSU Oklahoma College of Optometry, told the panel he has tracked training and published reviews showing large numbers of laser procedures performed by optometrists; he said a published dataset included about 46,000 procedures with two complaints registered to state boards. Student testimony noted workforce effects: Derek Bryant, an optometry student, said a survey of Kansas students found 90% consider scope of practice important when choosing where to practice and 96% would be more likely to return to Kansas if scope modernization passed.

Opponents argued the measures would allow nonphysicians to perform medical surgery and that the state’s surgical standard should remain limited to physicians. Senator Robert Clifford, an ophthalmologist who testified as a proponent of patient access but expressed concerns about unilateral scope expansion, recounted several cases he said illustrate the diagnostic and procedural complexity of eye care and warned of rare but serious complications after laser procedures. Dr. Mary Champion, president of the Kansas Society of Eye Physicians and Surgeons, said margins for error are small in the eye and cautioned that “improper technique or removal of these lesions can lead to spread of cancer throughout the body, scarring, disfigurement, or even blindness.”

The Kansas Medical Society and other physician groups opposed the bill. Rochelle Colombo, the society’s executive director, said physicians and surgeons undergo different training and regulation, and she urged that, if the legislature expands optometrists’ procedural authority, those practitioners be subject to equivalent regulatory and financial responsibilities such as participation in the health-care stabilization fund. Susan Guile, executive director of the Kansas State Board of Healing Arts, told the committee the board’s rule (KAR 100-20-7-1) requires an MD or DO to use lasers but allows delegatory authority if a physician is physically present; she said the bill raises questions about device definitions and a deletion in the draft that removes the word “topical” from prescriptive authority language.

Committee members pressed both sides on training pathways, frequency and severity of complications, and how the procedures are currently taught. Proponents described classroom, lab and supervised clinical training in U.S. optometry programs and continuing-education courses; opponents highlighted the medical-school/residency pathway and said residency-level experience changes clinicians’ diagnostic approach and ability to anticipate rare complications. Several testifiers pointed to differences across states: proponents said about a dozen states authorize similar optometrist procedures; opponents noted low billing rates for some codes in enabling states and questioned how much live-patient training happens in states that do not permit the procedures.

No formal committee vote was recorded during the hearing. Committee members said they would "work" the bill in committee the following day. The bill’s text, as described by staff, would: specify which procedures are included and excluded from the practice of optometry; remove certain definitions (transcript: “remove the definitions for the terms topical pharmaceutical drugs and oral drugs”); require applicants seeking credentialing to file a board application and pay a board-set fee; require the Board of Optometry to set credentialing standards to administer the specified procedures; authorize the board to seek injunctive relief for violations; and allow the board to maintain a public directory of licensees. The draft also contains an effective-date clause stating House Bill 2,223 would take effect on 07/01/2025 after publication in the statute book.

The committee’s next steps were not decided in the hearing transcript; staff said the committee planned to work the bill at a subsequent meeting.