North Dakota secures telemedicine provisions, ignites grassroots advocacy

A strategic move to modernize North Dakota’s scope of practice act to add telemedicine provisions, as well as grant greater board autonomy, resulted in a twofold win for the profession—not only a new law but also a rejuvenated grassroots movement. 

Signed into law on March 24 by Gov. Kelly Armstrong, HB 1267 primarily establishes clear and comprehensive guidelines for optometric telemedicine services with amendments to the state’s scope act to expand the North Dakota Board of Optometry’s authority. The product of a two-year collaborative effort by the North Dakota Optometric Association (NDOA) and the state board, HB 1267 addresses the growing need for clear guidelines in remote eye care while simultaneously marking a powerful resurgence of grassroots engagement within North Dakota. 

“This is a big win for North Dakota in so many ways,” says Kim Hacker, NDOA executive director. “We were successful in the passage of a bill to enhance safety and accountability around optometric telemedicine, but we did so much more.” 

Opening the scope of practice act 

Recognizing that North Dakota’s existing scope of practice act had remained untouched for over two decades, NDOA and the board jointly identified the need to define and implement clear guardrails for telemedicine services. A direct response to the increasing prevalence of online platforms delivering inconsistent, potentially substandard remote services, the guardrails would help ensure North Dakotans continue to receive quality patient care as technology permeates. 

Envisaged as a relatively straightforward bill, one that could help reestablish optometry’s presence in Bismark, HB 1267 encountered favorable support and no opposition—until a week before its hearing. That’s when the NDOA’s legislative team received word that ophthalmology intended to introduce an amendment defining and limiting optometric surgical procedures. In the eleventh hour, HB 1267 became a scope battle and the NDOA’s membership stepped up in a big way. 

“We created an absolute uproar in the state’s ophthalmology community—it was absolutely incredible what your membership can do,” Hacker says. “We had no idea the power our membership could have.” 

In rallying its members, the NDOA urged doctors to contact not only the legislators in their districts but also their referring ophthalmologists. Optometry wasn’t going for a scope expansion, but ophthalmology was using an amendment to define another profession’s procedures. Nowhere else would that be permissible, and North Dakota’s legislators agreed. 

HB 1267 passed with overwhelming majorities in both the House and Senate before receiving the governor’s signature weeks later. Now, the law is slated to take effect this summer. 

“Our members’ willingness to step up when called upon was truly incredible and we saw the passion our membership has for their profession,” Hacker says. “We built lasting relationships at the capitol and walked away from session with a positive reputation, and as many of you know, that’s half the battle.” 

Tapping into advocates’ support network 

The powerful display of the NDOA’s membership unity and advocacy proved instrumental in countering the proposed amendments, but it also couldn’t have come without the strategic engagement and support of fellow advocates.  

Guiding the NDOA’s newly formed legislative committee was the AOA’s State Government Relations Committee (SGRC) and advocates in nearby state affiliates, providing timely assistance not only throughout the legislation’s progression but also before the bill was even introduced. 

North Dakota’s advocates met with SGRC members at multiple points, including attending an AOA SGRC Regional Advocacy Meeting in Dallas that provided the state’s legislative team the actionable knowledge and opportunity to plan their strategy. 

“That was more instrumental for us as a group—everybody stepped up and learned together,” Hacker says. “We leaned on SGRC in a significant way, as well as our fellow affiliates, and for that we couldn’t be more grateful.” 

What is the AOA SGRC? 

The SGRC provides information, guidance, advice and resource assistance in all areas of state legislation and regulation affecting the profession of optometry to individual AOA members and affiliate associations, as well as to state legislators, regulators, third-party payers and more. As a comprehensive resource for state affiliates’ political activities, the SGRC also: 

• Serves as both a political and legislative resource for state affiliates. 
• Monitors state laws and regulations relating to the practice of optometry. 
• Monitors the impact that federal laws and regulations may have on state activities. 
• Maintains a database of state laws and regulations, as well as other comparative and analytical optometric legislative and regulatory databases. 

In addition to one-on-one affiliate consultations, the SGRC annually hosts regional advocacy meetings that promote collaboration among state advocacy teams, seasoned veterans and emerging leaders. For three years, these workshop-style meetings have featured panel discussions with advocacy experts, legislators and guest speakers, tackling topical content that can help affiliates’ advocacy. 

Interested in elevating your state’s advocacy? Save these dates for the 2025 AOA SGRC Regional Advocacy Meetings: 

• Aug. 15-16 | Chicago, Illinois 
• Oct. 24-25 | Phoenix, Arizona