Fiscal impact reports (FIRs) are prepared by the Legislative Finance Committee (LFC) for standing finance

committees of the NM Legislature. The LFC does not assume responsibility for the accuracy of these reports

if they are used for other purposes.

Current FIRs (in HTML & Adobe PDF formats) are a vailable on the NM Legislative Website (legis.state.nm.us).

Adobe PDF versions include all attachments, whereas HTML versions may not. Previously issued FIRs and

attachments may be obtained from the LFC in Suite 101 of the State Capitol Building North.

F I S C A L I M P A C T R E P O R T

SPONSOR SPAC

ORIGINAL DATE

LAST UPDATED

02/27/07

03/12/07 HB

SHORT TITLE

OPTOMETRY EXCLUSIONS & CERTIFICATION

SB

CS/367/aSJC/aSFl#1/a

SFl#2

ANALYST Hanika Ortiz

APPROPRIATION (dollars in thousands)

Appropriation

Recurring

or Non-Rec

Fund

Affected

FY07

FY08

NFI

(Parenthesis ( ) Indicate Expenditure Decreases)

SOURCES OF INFORMATION

LFC Files

Responses Received From

New Mexico Medical Board (NMMB)

SUMMARY

Synopsis of SFl Amendment #2

The Senate Floor Amendment #2 adds language restricting scalpel use to the skin surrounding

the eye.

Synopsis of SFl Amendment #1

The Senate Floor Amendment #1 adds an emergency clause that the Act takes effect immediately

upon being signed by the Governor. This will help bring current optometry practice in line with

State law as soon as possible.

Synopsis of SJC Amendment

The Senate Judiciary Committee Amendment adds language to exclude “surgery or injections in

the treatment of eye diseases" from the definition of the “practice of optometry".

SIGNIFICANT ISSUES

The Committee may wish to consider if the proposed exclusion includes cosmetic surgery, which

is not necessarily classified within “eye diseases".

CS/Senate Bill 367/aSJC/aSFL#1/aSF#2– Page

2

Synopsis of Original Bill

The Senate Public Affairs Committee substitute for Senate Bill 367 amends Section 61-2-2

NMSA 1978 by expanding the practice of optometry to include the use of the following types of

in-office minor surgical procedures:

•

the non-laser removal, destruction or drainage of superficial eyelid lesions and

conjunctival cysts;

•

the removal of non-perforating foreign bodies from the cornea, conjunctiva and eyelid;

•

the non-laser corneal debridement, culture, scrape or anterior puncture, not including

removal of pterygium, corneal biopsy or removal of corneal neoplasias;

•

the removal of eyelashes; and,

•

the probing, dilation, irrigation or closure of the tear drainage structures of the eyelid.

FISCAL IMPLICATIONS

The Optometry Board may need to increase the operational budget, and therefore increase

licensing fees, in order to provide the oversight required under the increased scope of practice;

however, evidence suggests the procedures as defined in the substitute have been adopted by the

Board for some time now and are current practice among optometrists.

SIGNIFICANT ISSUES

The SPAC substitute codifies into statute a set of minor surgical procedures optometrists in the

New Mexico have been performing for several years. According to the NM Medical Board, the

state statute specifically excludes surgery from the definition of the practice of optometry. The

Optometry Board reports that it has not received any complaints related to these procedures.

PERFORMANCE IMPLICATIONS

Optometrists provide most primary vision care. They examine people’s eyes to diagnose vision

problems and eye diseases, and they test patients’ visual acuity, depth and color perception, and

the ability to focus and coordinate the eyes. Optometrists prescribe eyeglasses and contact lenses

and provide vision therapy and low-vision rehabilitation. Optometrists analyze test results and

develop a treatment plan. They administer drugs to patients to aid in the diagnosis of vision

problems and prescribe drugs to treat some eye diseases. Optometrists often provide preoperative

and postoperative care to cataract patients, as well as to patients who have had laser vision

correction or other eye surgery. They also diagnose conditions caused by systemic diseases such

as diabetes and high blood pressure, referring patients to other health practitioners as needed.

Ophthalmologists are physicians who perform eye surgery, as well as diagnose and treat eye

diseases and injuries. Like optometrists, they also examine eyes and prescribe eyeglasses and

contact lenses.

PERFORMANCE IMPLICATIONS

State law allows optometrists who are certified by the Board to use oral or topical

pharmaceutical agents, to use the title of “Optometric Physician" and to advertise under the

“physician" and “physician-eye" headings of the yellow pages.

CS/Senate Bill 367/aSJC/aSFL#1/aSF#2– Page

3

CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP

Relates to SB 359; providing an avenue for a more objective review process for assessing

proposed changes in a health professions scope of practice.

TECHNICAL ISSUES

Current law provides for the administering and prescribing of certain oral and topical drugs by

optometrists; however, there is no provision to allow the administration of epinephrine by

injection for the treatment of anaphylactic shock.

OTHER SUBSTANTIVE ISSUES

Optometrists provide most primary vision care. Currently in the US there is an ongoing push by

optometrists to increase the scope of their practice. The American Academy of Ophthalmology

has been resisting these efforts. The American Medical Association’s recent “Scope of Practice

Study" and “Scope of Practice Partnership" is designed to provide backing to AMA members

who have scope of practice battles in their state. According to the AMA, the members of the

Partnership plan to fund research that helps refute key arguments allied health professionals use

to advance their measures in state legislatures. Funding will also be used to “help medical

associations fight expansions in non-medical scope of practice legislation in states where such

bills appear likely to advance." Currently the Partnership is comprised of six state medical

associations and six specialty groups including the American Academy of Ophthalmology.

WHAT WILL BE THE CONSEQUENCES OF NOT ENACTING THIS BILL

Actual practice will not conform to state law. The optometrists’ scope of practice established by

the Board of Optometry will remain in effect within board policy, rather than by statute.

POSSIBLE QUESTIONS

Optometrists serve patients in nearly 6,500 communities across the country, and in more than

3,500 of these communities they are the only eye doctors. How many communities in New

Mexico are served only by Optometrists.

AHO/nt