FRANKFORT — A measure that would expand the number of procedures optometrists are allowed to perform is headed to Gov. Steve Beshear's desk for his signature or veto.
Senate Bill 110, which would allow optometrists to perform some laser surgeries, was passed by the House on Friday in an 81 to 14 vote after a lengthy floor debate.
The bill is the first of the 2011 General Assembly to make it through both chambers. The Senate passed it 33 to 3 on Feb. 11.
The measure was filed Feb. 7 and has moved through the legislature in rapid fashion.
Beshear said Friday that he has not yet decided whether he will sign the measure.
"The governor is thoroughly reviewing the issues relating to the bill and plans on meeting with the interested parties before he makes a decision," said Kerri Richardson, a spokeswoman for Beshear.
Ophthalmologists — medical doctors trained to perform eye surgeries — oppose the bill. Optometrists do not attend medical school, but they do receive four years of optometry training after graduating from college and are trained to detect vision defects and prescribe corrective lenses.
Optometrists say the bill would allow them to perform a limited number of services that are needed, particularly in rural Kentucky where there are few ophthalmologists. By having more people perform the laser surgeries — which include post-operative procedures for cataracts and for glaucoma — the costs for such procedures will go down, they argue.
Optometrists and their political action committee have upped their donations to state leaders over the past year, campaign finance records show. In 2010, optometrists gave $250,000 to all political candidates, compared with just less than $50,000 in 2009, according to the Kentucky Registry of Election Finance.
House Speaker Greg Stumbo, D-Prestonsburg, said after the House vote on Friday that the optometrists have spent more than 18 months working on getting the bill passed. It was their lobbying efforts, not the hundreds of thousands of dollars in campaign contributions, that got the bill through both chambers, he said.
"That doesn't happen just because you made campaign contributions," Stumbo said. "That happens because you actually get out there and meet with the members. ... You have to credit the optometrists; they've been at it for more than a year and a half. It wasn't like they were hiding what they were doing."
Those who voted against the bill on Friday included the legislature's only two medical doctors, Rep. Bob DeWeese, R-Louisville, and Rep. David Watkins, D-Henderson.
Watkins was one of the most outspoken critics of the measure on the House floor. He asked that the bill be tabled so the House could do a thorough analysis of what it would cost the state's Medicaid system, a health care program for the poor and disabled. That measure, along with seven amendments that would alter the bill, was defeated.
"This is a dangerous bill," Watkins said. "I am not aware that they have any surgical training. I will never let an optometrist do a surgery on my own eyes."
But Rep. Dennis Keene, D-Wilder, who presented the bill on the House floor, countered that the optometry board would regulate and certify doctors before they are allowed to perform a limited number of eye procedures using lasers.
Rep. Danny Ford, R-Mt. Vernon, said that when the legislature approved a measure to allow optometrists to use eye drops more than 20 years ago, they heard similar concerns from ophthalmologists. But those problems never materialized.
"It has saved a lot of money for the Medicaid system," Ford said of the earlier expansion of optometrists' duties.
But Dr. Woodford Van Meter, president of the Kentucky Academy of Eye Physicians and Surgeons, said ophthalmologists might sue the state because they believe the bill was not referred to the appropriate committees.
The House and Senate referred the bill to their respective Licensing and Occupations committees even though their rules say issues regarding optometry should be referred to the chambers' Health and Welfare committees, Van Meter said.
During Friday's house debate, Watkins questioned whether the bill had been sent to the appropriate committee. But Stumbo said House leaders felt the matter could have been referred to either Health and Welfare or Licensing and Occupations. Because the Senate heard the bill in the Licensing and Occupations Committee, the House decided to send it to the same House committee.
However, questions about where the bill should be referred should have been addressed earlier in the week when the bill was assigned to the Licensing and Occupations Committee, Stumbo said.
Van Meter said his group will seek an opinion from the Kentucky Medical Association on whether a legal challenge would be feasible.
If Beshear signs the bill, Kentucky will look foolish, he said. Only Oklahoma has passed such a bill. Twenty-five other states have defeated similar measures.