ODs get expanded prescribing rights in Arizona, Nebraska

New laws in Arizona and Nebraska expand optometrists' prescribing authority—and improve timely patient access to needed treatments.

"It's been a long-term advocacy effort."

Strong lobbying efforts and good relationships with state lawmakers helped make both bills a reality.

"The AOA applauds the efforts of Arizona and Nebraska for advancing eye care," says AOA's State Government Relations Committee Chair Deanna Alexander, O.D. Despite challenges from ophthalmology and the medical societies, optometry was "still able to make some very positive changes for its patients. AOA is here to work with affiliates and respond to any challenges from medicine."  

The Arizona Optometric Association (AzOA) has worked hard to "build up a reservoir of good will with state legislators," says AzOA Legislative Chair Annette Hanian, O.D. AzOA also drew support from the AOA and other state affiliates to get this bill signed into law.  

Dave McBride, executive director of the Nebraska Optometric Association concurs, saying that the AOA provided research support and perspectives gained from other states. "We really appreciated the cooperation and timely responses we received from AOA staff on questions that came up during this process."  

Continued success in Arizona
Over the past six legislative sessions, AzOA has expanded OD scope of practice through several bills. The most recent goes into effect July 23.  

ODs now will be able to prescribe additional classes of oral medications: oral versions of steroids, fluoroquinolones and glaucoma drugs. Arizona ODs already have the authority to prescribe schedule III analgesics such as hydrocodone and codeine, but the new law expands that authority to schedule II.

"[This] will maintain our prescriptive authority for these drugs when the Food and Drug Administration reclassifies them later this year from schedule III to schedule II," says Dr. Hanian.

Even more important, the law takes away a provision that had imposed restrictions and requirements for ODs to consult, refer and document to ophthalmologists. Under the change, ODs are more directly responsible for their own patients, Dr. Hanian says.  

Five years of advocacy pay off
In Nebraska, a five-year bid to get a scope of practice bill approved paid off, thanks to the efforts of the Nebraska Optometric Association (NOA) and the AOA. The new legislation removes any remaining restrictions for ODs on oral prescriptive authority.  

The law means ODs will have the ability to prescribe oral steroids, glaucoma drugs and immunosuppressant medications. It also includes authority for ODs to use injections for anaphylaxis, such as EpiPens.  

"It's been a long-term advocacy effort on the part of NOA," says McBride. The law takes effect July 22.

Quicker access to needed medications
Because of the Nebraska law, patients can access needed medications from their OD without having to go through multiple visits, follow-ups and waiting periods, says Christopher Wolfe, O.D., the NOA's legislative chair, who practices in Omaha.  

Oral medications help ODs quickly resolve eye discomfort for patients, he explains.  

The new law is an important step forward, but it didn't contain everything the NOA wanted to accomplish, McBride says. For example, the law does not include language that would have allowed ODs to perform minor surgical procedures. "We've got more work ahead of us," he adds.

May 23, 2014

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