Minutes of

North Carolina State Board of Optometry

July 31 – August 4, 2008

Jane McKimmon Center

Raleigh, North Carolina

 

 

 

The North Carolina State Board of Optometry met in Raleigh, North Carolina, Thursday, July 31 through Monday, August  4, 2008 at the Jane McKimmon Center on the Campus of North Carolina State University to conduct the Summer 2008 Clinical/Practicum Examinations, to hear reports from the officers and staff, to review complaints and for other purposes.  Present were Drs. Joel Banks, President, William Hendrix, Secretary/Treasurer, David Anderson, Michael Clark, William Rafferty and Mr.  Roger Mitchell and Ms. Mary Richardson, Members of the Board.  Present as Staff were John D. Robinson, OD, Executive Director, Janice Peterson, RN, Administrative Secretary, and Ms. Sara Roberts, Administrative Assistant.  Mr. Johnny Loper, the Board’s Attorney, was present on Friday to meet with the Board in closed session to discuss litigation matters pursuant to GS 143-318.11(a)(3).  Present as Clinical Examiners were: Drs. Jill Bryant, Kenneth Bumgarner, Ania Hamp,  Donald MacQueen, Magda Metwalli, John Miller, Sandra Moore, Brett Munn, Eric Oberdorf and Robert Rosenstein. Present as observers for a full day over the course of the examinations were Drs. Jamie Casper, Wynne Martin, Michael Carstens, Andy Cook, Jason Price, Kevin Payne and Lee McPherson. Attending the open sessions on Friday representing the North Carolina Society of Eye Physicians and Surgeons (SEPS) was Mr. Byron Nelson. 

 

From 4 to 5:30 p.m. Dr. Rafferty reviewed the examination scenario construction on personal computers using the template supplied with the Clinical Examiners. Following the review there was a short session critiquing the process after which he and Dr. Jill Bryant ‘staged’ three mock scenarios which the Clinical Examiners were asked to score.  The purpose of the exercise was to demonstrate consistency or lack thereof in scoring.

 

At 5:30 p.m. Dr. Banks called the Board meeting to order and offered an opening prayer.  

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APPROVAL OF MINUTES.  On a motion by Dr. Anderson seconded by Mr. Mitchell and carried unanimously, the Minutes of the Meeting held in Myrtle Beach, June 5 - 7, 2008  were approved.

 

On a motion by Mr. Mitchell seconded by Ms. Richardson and carried unanimously, the minutes of the Annual Meeting held at noon on June 5, 2008 were approved.

 

REPORT OF THE PRESIDENT.  Dr. Banks having been in office for only one month had no formal report.  However, he did take the opportunity to thank the Members of the Board for their trust and faith in his leadership abilities by electing him to serve as President for the 2008 - 2009 fiscal year.   

 

On a motion by Ms. Richardson seconded by Dr. Clark and carried unanimously the report of the President was accepted.

 

REPORT OF THE SECRETARY/TREASURER.  Dr. Hendrix presented the Budget Report for the period 07/01/08 through 07/31/08.   Attention was called to line item # 606, postage, under expenses because the amount appeared to be rather large given the short period of time involved.  During brief discussions It was pointed out that Federal Express, used to send examination materials to the Clinical Examiners and their licenses to the new licensees, has begun adding ‘fuel’ surcharges to their billings. The amount of the surcharges are now approximating the charges for the shipping .   Without further discussion on a motion by Dr. Clark seconded by Mr. Mitchell and carried unanimously the report of the Secretary/Treasurer was accepted. 

 

REPORT OF THE EXECUTIVE DIRECTOR.  The Executive Director began his report by stating that he along with Drs. Hendrix and Rafferty attended the recent meeting of the Association of Regulatory Boards in Optometry in Seattle, WA and that  he and Dr. Hendrix were also in attendance at the American Optometric Association’s House of Delegates.  He then proceeded to make the following report on the two meetings and his personal observations of the events taking place over the six day period:

 

 

 

 

 

 

In concluding this portion of my report on ‘Board Certification’, I was in communication with a long time friend and colleague whose career in optometric education spans the better part of the past half century and who continues as a highly regarded and respected leader in the optometric profession nationally, who had these words concerning  ‘Board Certification’ in optometry following the Seattle meetings:

 

”I assert that, if legal challenges follow implementation, it can be demonstrated that the major organizations in optometry converged to form a ‘combination in the form of a trust’ or a ‘conspiracy in restraint of trade’ [see Sherman Act, 190] [see, also, Clayton Act, 1914] to designate ‘Board Certification’ to those O.D.’s who demonstrate continuing clinical competence in practice consistent with their original license issued by a state authority. Failure to become ‘Board Certified’, I hold functionally diminishes the state document.  Moreover, the commonly accepted designation of ‘Board Certified’ refers to demonstrated and evaluated advanced clinical competence in a recognized clinical specialization.”

 

In your meeting notebook there are drafts of:

 

a response to an inquiry from Ms. Rhonda Owens at the NCDHHS concerning eye care services provided to nursing home patients by optometrists and ophthalmologists.  Since the inquiry came in shortly before the scheduled start of this meeting, I informed Ms. Owen that I would delay a response until after the Board reviewed  the matter; and

 

a ‘policy statement’ on the wide spread sale without prescription of ‘cosmetic’ contact lenses throughout the state by non-licensed persons in mini-markets, beauty and nail salons, flea markets and elsewhere.  If approved the statement will be added to Board Policy Statements on the Board’s web site as part of the Policy on Spectacle and Contact Lens prescription release.

 

Finally, I would be remiss in my responsibilities as Executive Director of this Board if I did not include in this report the following series of events that began while in I was Seattle in June. It was on Thursday during a break in the AOA House of Delegates that I received word from the Society office that the Society leadership (most of whom were in Seattle) had received an ‘invitation’ to have representatives attend a meeting being held by the North Carolina Society of Eye Physicians and Surgeons (SEPS) and the North Carolina Medical Society at their offices in Raleigh on the Monday afternoon following their return from Seattle the day before (Sunday) the meeting was to take place asking for their input on ‘a definition of surgery’. The invitation was declined because of the short time frame between receiving the notice and the date of the meeting and the fact that most of the Society’s leadership were out of state at the time it was received.  On returning to the office I discovered that a ‘definition’ of surgery had been prepared for introduction as a ‘committee substitute’ for an unrelated bill passed by the House during the regular session that was awaiting action in a Senate Committee.  The proposed ‘Committee substitute’ was to amend the optometry practice act to include a definition of surgery similar (if not identical) to one in a bill introduced in the regular session that was to amend the medical practice act to add a definition of surgery, said definition by all appearances aimed at restricting the scope of practice of optometry heretofore agreed to by the Boards of Optometry and Medicine (that bill was never voted on by Committee prior to the adjournment of the regular session, thus ‘dying’ and not eligible for consideration during the short session).   An attempt to amend the optometry practice act by SEPS, one of several medical specialties organized under the umbrella of the North Carolina of Medical Society, was a brazen attempt to deny patients access to properly trained and licensed optometrists for their care.  Clearly, the issues at stake are economic, not patient safety.  The purpose behind SEPS’ efforts to amend the optometry practice act  is meant to impose restrictions on properly trained and licensed optometrists favorable to economic well being of their own members.   The issue is one that goes far beyond differences between professional organizations representing their membership.  It is an issue involving the licensing and regulatory authority of the State Board of Optometry whose practice act members of another profession proposes to amend.  It is now the Board of Optometry’s fight  because of its obligation to protect its practice act from amendments that would impose scope of practice limitations on its licensees to the financial advantage of those behind the movement.   Further, such actions by those representing the North Carolina Society of Eye Physicians and Surgeons (SEPS) are not only ‘threatening’ to the  optometric profession at large but their success in imposing restrictions on the practicing optometrist would be to the detriment of their (the optometrist’s) patients and their access to appropriate care.   Fortunately the effort failed; however, in all likelihood we have not heard the last of this movement.  The word  is out  that there will be  a concerted effort in the 2009 session of the legislature to  introduce and pass an amendment to the optometry practice act that will place meaningful restrictions on the practice of optometry in this state.    

 

Mr. President, I recognize that this report is long and goes into considerable detail in describing the events occurring at the ARBO and AOA meetings in Seattle concerning ‘Board Certification’ and the events that began to unfold at the legislature just weeks before the adjournment of  the 2008 session, but the issues are critical to the future regulation of the practice of optometry by the licensees of this Board and goes to the heart its ‘purpose for being’, the assurance to the public that those who are licensed are not only competent at the time of initial licensure but remain competent to practice the full and lawful scope of practice of optometry in North Carolina, else the Board would have the responsibility of placing restrictions and/or conditions on their ability to continue practice. Further, an attempt by SEPS to amend the NC Optometry Practice Act demands the full and undivided attention of this Board and a commitment of those resources it commands to defeat such efforts. Thank you for listening and this concludes my report.

 

On a motion by Dr. Rafferty seconded by Mr. Mitchell and carried unanimously the report of the Executive Director was accepted.

 

There was a brief discussion of the draft of the response to Ms. Owen at NCDHHS on eye examinations in nursing homes.  Mr. Mitchell had questions with portions of the response, so in the interest of time it was agreed that the Executive Director would meet with Mr. Mitchell over the course of the next several days to address and/or clarify any issues about which he expressed concern.  Further, that unless there were substantive changes made in the response that it be sent to Ms. Owen following final review by the President.

 

Illegal Sales of Cosmetic Contact Lens.  On a motion by Dr. Anderson seconded by Dr. Clark and carried unanimously the Board approved the statement on the illegal sale of cosmetic contact lens and directed that it be added to the current Board Policy Statement on the prescribing and releasing of prescriptions of spectacle and contact lens and posted on the Board’s web site under ‘Board Policy’.

 

CLOSED SESSION.  On a motion by Dr. Anderson, seconded by Mr. Mitchell and carried unanimously, the Board went into Closed Session to discuss matters of litigation pursuant to GS 143-318.11(a)(3).  In closed session Mr. Loper discussed with the Board a situation which may lead to litigation.  Mr. Loper described the situation, briefed the Board on the alternatives, and answered procedural and substantive questions from the Board.  On motion by Mr. Mitchell seconded by Dr. Anderson and carried unanimously the Board  voted to return to open session. No vote or other action was taken by the Board in the closed session.

 

 

CLINICAL EXAMINERS HONORARIUM.   On a motion by Dr. Clark seconded by Ms. Richardson and carried unanimously the Board approved that five days honorarium be paid to each of the Clinical Examiners including Dr. David King who agreed to be on 2 hour call from Thursday P.M. through Monday A.M. in the event of an emergency and for all travel and meal expenses as required for each of them.

 

NEW BUSINESS          There was no new business

 

OLD BUSINESS.     There was no old business

 

EXAMINATION OF THE CANDIDATES.  Forty-seven candidates whose applications had been approved appeared for examination.  The first session began at 7:45 a.m. on Friday August 1, 2008 and the last session ended at 10:20 p.m. on Monday August, 4, 2008. 

 

Their being no further business on a motion by Dr. Clark seconded Dr. Rafferty and carried unanimously the meeting was adjourned at 11:15 a.m. on Monday, August 4,2008

 

The next meeting of the Board to determine the results of the Summer 2008 Clinical/Practicum Examinations and to consider other matters that might come before the Board will be held at the Board Office in Wallace beginning at 4 p.m. on Friday, August 22nd and end no later than 5  p.m. on Saturday, August 23, 2008.

 

 

 

                                                                                                Approved 08/22/08

                                                                                                Wallace, NC