Sen. Rebecca White backs S.64 to let specially credentialed optometrists perform defined minor eye surgeries, lasers and injections

Sen. Rebecca White (Windsor County) and officials from the Office of Professional Regulation told a legislative committee that S.64 would create an "advanced therapeutic procedure specialty" enabling some Vermont optometrists to perform a limited set of minor ophthalmic surgeries, laser procedures and injections after meeting new training and competency requirements.

"This is an act relating to amendments to the scope of practice for optometrists," Dijon Harvey, legislative counsel, said as he read the bill caption and summary for the committee. The bill would add "therapeutic pharmaceutical agents" to optometrists' authorized practice for diagnosis, management and treatment of the eye and adnexa, and establish an explicit list of procedures that specialty holders may perform and a separate list of procedures that remain prohibited.

Jennifer Kahl, director of the Office of Professional Regulation (OPR), said OPR reviewed experience in other states and has concluded that, with the bill's training and oversight, the specified expansion is appropriate. "We feel comfortable with the scope expansion," Kahl told the committee, citing OPR sunrise reviews in 2019 and 2023 and the availability of competency assessments and reporting requirements in S.64.

Under the bill, an optometrist who holds the specialty must meet multiple requirements: a post‑2019 optometry graduate may already have the curriculum incorporated in training; optometrists who graduated before 2019 must complete a minimum 32‑hour postgraduate didactic course; a supervised preceptorship requires at least 8 hours of in‑person clinical training that includes specified, hands‑on procedures on live patients (Harvey listed minimum counts such as at least two laser trabeculoplasties and at least two chalazion excisions); candidates must pass national written and clinical examinations administered by the National Board of Examiners in Optometry; and specialty holders must complete an additional five hours of continuing education for the specialty during each two‑year license cycle.

The bill also lists prohibitions: it would bar optometrists from major ophthalmic surgeries (including corneal transplants, removal of the eyeball, procedures requiring general anesthesia, and several retinal and vitreous surgeries). Harvey told the committee there are "23 procedures and other activities" explicitly prohibited, and he read statutory language guarding that line. S.64 includes a narrow controlled‑substance exception: an optometrist may prescribe a hydrocodone combination for pain but not more than a 72‑hour supply and with no refills, the bill says.

OPR officials emphasized the state's workforce context in urging support. "If a professional group has the training, experience, knowledge to be able to perform, like in this case, these advanced procedures, then we like to remove those barriers and allow them to do that just to increase access," Kahl said. OPR told the committee it identified about 168 licensed optometrists in Vermont and roughly 33 ophthalmologists, with ophthalmologists more concentrated in urban centers.

Some committee members pushed back on the bill's prescriptive approach. "I find it deeply disturbing that a 180 political members of the General Assembly are put in a position to make medical decisions on procedures that we can't even pronounce," one member said, asking why so many procedure‑level details are written into statute rather than left to rulemaking. OPR witnesses said specificity has arisen in past debates where the subject was controversial and that a legislative list provides clearer oversight for stakeholders who want that constraint.

The committee also heard a patient account underscoring access concerns. A witness who identified herself as Britney, a licensed clinical mental health counselor, described an eyelid infection that progressed over months after delayed specialist availability and multiple treatments. "If I could have gotten into an optometrist where there are more of them, in the state of Vermont to take care of this, I wouldn't have had all of the issues," she said, describing additional pain, missed work and expenses tied to delays in care.

Harvey noted additional implementation details in the bill: specialty credentials could be issued by endorsement to out‑of‑state practitioners with at least three years of equivalent practice; specialty applicants must log preceptorship procedures for board review; specialty holders must report any adverse event related to an advanced procedure within 30 days; and the Senate‑amended effective date in the bill is July 1, 2028. OPR representatives said the specialty credential carries a $100 initial application fee and that the agency expects to seek a renewal fee in future rulemaking or legislation to fund ongoing oversight.

No formal committee vote was recorded during this panel. Members asked OPR to provide concise synopses of the 2019 and 2023 sunrise reports and signaled they may call additional witnesses. The committee recessed for the morning without taking final action on S.64.

Sources and clarifying details drawn from committee testimony and counsel's reading of the bill: the proposal creates a defined specialty with education (32 hours for pre‑2019 graduates), at least 8 hours of supervised clinical preceptorship with minimum procedure counts, NBEO written and clinical examinations, an extra 5 hours of specialty continuing education every two years, a 72‑hour hydrocodone prescribing limit exception with no refills, an adverse‑event reporting requirement within 30 days, an estimated 168 optometrists and ~33 ophthalmologists in Vermont, and a Senate‑amended effective date of 07/01/2028.