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Kentucky optometry board defends emergency rule allowing alternate exam pathway for some licensees
Summary
The Kentucky Board of Optometric Examiners told a legislative subcommittee its emergency regulation (201 KAR 5021E) is a measured response to an attorney general opinion and provides a temporary alternative pathway (ABO certification) for certain 2020–2023 licensees to cure procedural defects; medical examiners and patient advocates warned the substitute could undermine hands‑on competency checks and risk patient safety.
Dr. Marybeth Morris, president of the Kentucky Board of Optometric Examiners, told the Administration Regulation Review Subcommittee that the board filed emergency regulation 201 KAR 5021E to address procedural defects identified in an October 2025 attorney general opinion and to ensure public protection while it completes a review of certain licensees.
"Protecting the public remains the board's highest priority," Dr. Morris said, describing the board's decision to use the American Board of Optometry (ABO) certification as a temporary, limited pathway for optometrists licensed between 2020 and 2023 who obtained licensure under alternative testing or waiver processes during the COVID era.
The board explained the attorney general concluded waivers or alternative testing had not been adopted through the formal regulatory process, so the board withdrew an earlier emergency rule and refiled the current regulation in February. The board said it will require affected clinicians to demonstrate passage of required exams before license renewal in 2027 and will recognize exams taken while the previously filed regulation was in force (07/30/2025–04/15/2026).
Public commenters and national exam authorities urged the subcommittee to find the emergency regulation deficient. Dr. Christina Kemp, a clinician contracted with the Kentucky School for the Blind Charitable Foundation, described cases in which children experienced missed specialist referrals and late diagnoses and said the foundation views "one child" harmed as too many. "When testing requirements are waived or alternatives are given, the safeguard is removed," Kemp said.
Dr. Patrick O'Neil, speaking for the Association of Regulatory Boards of Optometry (ARBO), said the ABO certification is not a substitute for the National Board of Examiners in Optometry (NBEO) examination series and told the committee the regulation fails to address imminent public‑safety threats, lacks adequate cost analysis, and exceeds the board's authority. "This emergency regulation does not help protect the citizens of Kentucky," O'Neil said.
Dr. James Campbell, representing the NBEO, described NBEO Part 3 as a hands‑on clinical examination delivered at a single national center using standardized patients and multiple stations to evaluate clinical skills. He said ABO certification is a computer‑based, post‑licensure credential and "substituting the American Board of Optometry certification for the NBEO Part 3 is akin to granting a light driver's license to an applicant who skipped the driving road test."
Committee members, led by Senator West, asked witnesses about practical differences — test format, frequency and costs, and whether any other state uses the ABO exam for initial licensure. Witnesses said NBEO Part 3 is administered at a single center in Charlotte and that no state uses ABO for licensure; one witness said the NBEO Part 3 fee is $1,490.
Office of the Attorney General counsel Christopher Thacker told members that the AG opinion addressed procedural (KRS chapter 13A) defects in how waivers were issued and did not itself declare licenses invalid. He said the board has discretion to choose alternative tests in regulation but must do so through proper rulemaking. The board told the committee it sought a reasonable cure that balances due process for clinicians who have been practicing for years and public protection.
The subcommittee approved a staff amendment to the regulation without objection. Several members asked how many licensees are affected; witnesses referenced a list of 21 individuals disclosed by media reporting but said a definitive total was "not specified" while investigations continue. Representative Bridal noted students followed the board's prior guidance and said a reasonable cure period was appropriate to avoid undue hardship.
The committee closed the optometry item and moved to other regulations. The board and national exam bodies will likely continue discussions about a permanent, administratively adopted testing standard for initial licensure.
