Ophthalmologist-led coalition looks to Arkansas ballot to unwind new law on optometry eye surgery

A coalition of Arkansas doctors are looking to deploy a rarely used ballot referendum to knock a new law off the books that would allow optometrists to perform eye surgeries and other procedures once limited to medically trained ophthalmologists.

That group, Safe Surgery Arkansas (SSA), on Tuesday (June 11) filed papers at the State Capitol to form a ballot question committee to coordinate a statewide referendum challenging Act 579 of 2019. That new law opens the door for licensed optometrists, who were previously prohibited from using lasers, scalpels and injections in their local practice, to now perform those surgical procedures in Arkansas.

Supporters of the ballot referendum said in a news release that the eye health of Arkansans is at stake if Act 579 goes into effect. The group said a survey commissioned by the Arkansas Medical Society earlier this year found that 65% of Arkansans opposed allowing optometrists to perform surgeries with lasers and scalpels.

“Every day the people of Arkansas rely on medical doctors who have the experience and training to perform medical procedures to ensure that they are getting world class healthcare in Arkansas,” R. Scott Lowery, president of the Arkansas Ophthalmological Society, said in a statement. “We are confident that when the people are heard on this issue, they will not allow individuals without medical degrees and without surgical residencies to jeopardize the precious eyesight of Arkansans.”

However, Vicki Farmer, executive director of the Arkansas Optometry Association, told Talk Business & Politics her trade was disappointed to learn that “special interests” groups formed the new coalition to unwind Act 579.

“Arkansas legislators overwhelmingly approved this measure during the recent session, after listening to hours of testimony and debate, and learning optometrists in other states, like Oklahoma, have been safely performing these procedures for more than 20 years,” said Farmer, whose association strongly backed Act 579 during the legislative session. “Lawmakers also heard from constituents who have had to endure added costs and lengthy waits when required to see a specialist for care their optometrist is trained to safely provide. “

Farmer said the Arkansas General Assembly had fully vetted the legislation and determined that the new law will give Arkansas patients increase access to quality care.

“We think voters will agree,” she said. “We encourage folks to learn the facts before signing the petition, which will likely be circulated by paid canvassers.”

While the Arkansas Constitution authorizes referendums on any act of the General Assembly, the provision submitted by Safe Surgery Arkansas has only been deployed once in the last 50 years, according to Alex Gray, an attorney for the Steel Wright Gray law firm in Little Rock that drafted and filed the referendum at the Secretary of State Office today.

Gray said the group he is advising has about 45 days to get the necessary 53,941 signatures from registered Arkansas voters to put the referendum on the ballot next fall. Unlike an initiated act or constitutional amendment that respectively requires 8% and 10% of signatures from voters from the last gubernatorial election, the prerequisite for a statewide ballot referendum is not as tall.

Under Article 5, Sec 1 of the Arkansas Constitution, the people of Arkansas have the right to refer to voters any act of the Legislature. However, they must get signatures from 6% of those who voted in the last gubernatorial election and submit them to the State Election Board no later than 90 days after sine die of the General Assembly, which adjourned on April 10.

If Safe Surgery Arkansas gets the required number of signatures to get the measure on the ballot and those names are approved by state election officials, Act 579 would be suspended until people voted during the presidential and general election in November 2020. Gray said the group filed June 6 a “statement of organization” with the Arkansas Ethics Commission.

“I think we will be able to get the needed signatures,” Gray told reporters at the State Capitol as he filed papers to form the ballot question committee at the Secretary of State’s Office. “We’ll have to spend a considerable amount to obtain signatures and pay for canvassing especially since it is a short timeline.”

As it was enacted and signed by Gov. Asa Hutchinson, Act 579 does not include an emergency clause and will go into effect July 23 if the necessary signatures are not obtained by Safe Surgery Arkansas. Gray said the coalition includes the state Ophthalmological Society and other members of Arkansas medical community. He also stressed that ophthalmologists are medical doctors who must have four years of medical school, a one-year hospital internship and three-year surgical residencies. He said optometrists are not medical doctors and instead complete a four-year program to study eye care, including fitting glasses and contact lenses.

During the legislative session, Act 579 was one of the more controversial and longest-debated bills during the 92nd General Assembly. It was first introduced by sponsor Rep. Jon Eubanks, R-Paris, as House Bill 1251 only 10 days after session begin on Jan. 14. It did not move out of the House Public Health, Welfare and Labor Committee until March 5, and was approved by the full House a day later in a vote 70-19 and 10 representatives not voting. It moved out of the namesake Senate committee on March 19 and was approved by the upper chamber the next day in a vote of 25-8. The enrolled bill was subsequently transmitted to Gov. Hutchinson on May 21, and he signed the legislation into law a week later.

In other states, optometrists have been successful in broadening their permissible scope of services. States such as Louisiana, Oklahoma, and Tennessee allow optometrists to perform various types of procedures once limited to ophthalmologists. States such as Texas and Illinois, have ignited the debate, but not adopted any significant changes.