Consistent and focused advocacy is critical to the long-term viability of ophthalmology and the delivery of quality medical eye care in Wisconsin. And the WAO is an active force in the State Capitol working on health care issues of importance to WAO members that impact the practice ophthalmology. Our comprehensive advocacy program aims to:

1. Strengthen the image of the practice of ophthalmology and educate policymakers on the importance of medical eye care; and
2. Provide public policy leadership to enhance the practice of ophthalmology and ensure high standards for medical eye care are maintained in Wisconsin.

Of course, our most effective advocacy efforts actively engage WAO members in their strategy and execution – aiming to capitalize on the expertise of our physician members.

Member participation in WAO’s advocacy programs is increasingly important, as we are facing two highly concerning policy challenges in the 2023-24 legislative session: 1.) The reintroduction of the APRN bill that would authorize broad independent nursing practices in Wisconsin; and 2.) Efforts by optometrists to expand their permissible scope of services to include laser surgeries.

Thankfully, WAO is well-positioned to act on these issues. In addition to our direct lobbying efforts thorough our professional lobbying firm (HZW), we have several grassroots advocacy programs in place to influence public policy at the state level. If are not already involved, WAO encourages you to participate in the following two key programs to strengthen our influence in the Wisconsin Legislature and ultimately help us meet our legislative/regulatory goals:

Participate in the WAO Capitol Connection Program

In WAO’s ongoing effort to raise the profile of ophthalmology and our organization in the State Capitol, we have established our Capitol Connection program to encourage WAO members to invite their local legislators to visit their clinics and facilities.

The program is designed to help WAO members build and strengthen working relationships with legislators and offers a unique face-to-face opportunity to educate them about the importance of ophthalmology and medical eye care. Through the Capitol Connection program, lawmakers can learn firsthand what is important to the ophthalmology community. In many cases, just a single meeting or contact can have a significant impact on a legislator's view or position on a legislative issue.

With potential scope of practice legislative battles on the horizon, it’s more important than ever for WAO members to connect with their state lawmakers to discuss the critical role of ophthalmology, as well as the level of education, training, and knowledge required of ophthalmologists.

To date, we have held multiple successful legislative tours and have several more being planned for the near future. Hosting a legislator at your site is easy, enjoyable, and can make a significant advocacy impact, so we would encourage all WAO members to participate in this highly effective advocacy program.

If you would like to host a legislative tour at your site, please contact the WAO office at wao@badgerbay.co. We will work with you and your legislators to coordinate the meetings and will provide participating members with full support, including legislator bios, advocacy tips, issue briefings, and supporting documents. 

Contribute to the WAO Political Action Committee

The Wisconsin Academy of Ophthalmology is committed to offering a wide collection of member services and programing. That includes a comprehensive government affairs program that provides direct lobbying services and grassroots advocacy strategies to increase WAO’s presence in the State Capitol and help shape policy decisions that preserve and enhance the practice of ophthalmology in Wisconsin.

One of the most effective advocacy tools the WAO has as its disposal is the Ophthalmologists for Better Government Political Action Committee (PAC). The PAC allows WAO to collect contributions from members into a single account to support candidates for state legislative office who understand and support issues important to ophthalmologists, the practice of ophthalmology, and Wisconsin’s House of Medicine.

Contributing to our PAC is more important than ever, as optometrists have been successful in expanding their permissible scope of services in several other states – and the debate is heating up in other parts of the country. Wisconsin could very likely be next…

The best way we can win these legislative battles is to significantly enhance our legislative advocacy outreach, and having a robust, well-funded PAC is critical to our efforts. With strong member participation in the Ophthalmologists for Better Government PAC, we will be well positioned to preserve the Ophthalmology scope of practice in Wisconsin.

As mentioned above, the WAO PAC is funded through contributions from ophthalmologists across the state and is only effective as a political tool if members participate in the program. With that in mind, please take a few moments and contribute online TODAY to the Ophthalmologists for Better Government PAC. Every dollar helps, as the risk of non-involvement in the political process is getting too high to ignore.

To ensure the voice of citizens is heard across state government, it is critical for Wisconsin residents to understand our electoral process, and even more important for them to cast their vote on election day. And a big election is right around the corner… Wisconsin’s 2023 Spring Election will take place on Tuesday, April 4, and voters will head to the polls to cast their ballots in the WI Supreme Court Race, which could decide the ideological direction of the court for years to come.

In the Feb. 21 Spring primary, Milwaukee County Circuit Judge Janet Protasiewicz and former Supreme Court Justice Daniel Kelly captured the most votes in the four-way race and will face-off in the April 4 general election. Protasiewicz took 46% of total votes cast, with Kelly coming in a distant second, capturing 24% of the votes. Again, the winner of the general election will decide the ideological direction of the 7-seat high court, which is currently controlled 4-3 by conservative-leaning justices.

In addition, for those of you who live in the 8th Senate District (in southeastern Wisconsin), there is a special election to replace Sen. Alberta Darling (R) who retired from the Wi Senate late last year.  Republican State Representative Dan Knodl is running against Democrat environmental attorney Jodi Habush Sinykin.

For more information about the April 4 Spring Election, including your polling place and which candidates and referendum questions will be on your ballot, simply CLICK HERE. 

Earlier this month, longtime Wisconsin Secretary of State Doug La Follette announced his retirement. La Follette, who was recently reelected to another four-year term in Nov. 2022, was first elected to the office in 1974 and has held the position for 44 years. Gov. Tony Evers has appointed Former Wisconsin Treasurer Sarah Godlewski to replace La Follette and serve out the remainder of his term.

Earlier this month, the WAO had the opportunity to ask State Representative Clint Moses (R-Menomonie), Chair of the Assembly Health, Aging and Long-Term Care Committee, what his health care-related policy goals are for the 2023-24 legislative session. Here is what he had to say:

“My health priorities this session are to address the healthcare workforce shortage and to help make healthcare more affordable and accessible for Wisconsin citizens. Throughout Wisconsin, the health care workforce shortage has reduced accessibility to quality care. We have seen reduced service options and closures of clinics. In many cases, people are driving over an hour plus for a routine checkup. This creates a challenging situation for patients, especially for our aging population who face increasingly difficult decisions when it comes to their healthcare. I have been spending time learning about regulations surrounding Senior Care, IRIS, Nursing Homes, and Hospitals services across the state. I have also been on numerous tours in health care facilities and have met with many health care providers. I look forward to working with all the stakeholders to make Wisconsin a healthy state for all ages.”

Representative Clint Moses (R-Menomonie) represents the 29^th Assembly District in northwestern Wisconsin, which includes portions of Dunn and St. Croix Counties. He was first elected to the Assembly in 2020 and was reelected in 2022. He currently serves at the Chair of the Assembly Health, Aging and Long-Term Care Committee. Rep. Moses, who resides in Menomonie with his wife and four daughters, is a chiropractor by trade. He operates Red Cedar Chiropractic with his wife, Dr. Nora Moses, and has been caring for residents of Dunn County for 20 years. He is a member of the Chiropractic Society of Wisconsin, Community Foundation of Dunn County, lifetime alumni member of Northwestern Health Sciences University, and has served on the Colfax Health & Rehabilitation Board.

Earlier this month, a group of state lawmakers led by Sen. Patrick Testin (R-Stevens Point) and Rep. Gae Magnafici  (R-Dresser), announced plans to reintroduce the Advanced Practice Registered Nurse (APRN) bill. The proposal, which is opposed by the WAO, the Wisconsin Medical Society, and other physician specialty groups, is similar to legislation vetoed by Gov. Tony Evers last session that would have authorized broad independent nursing practices in Wisconsin.

More specifically, the legislation would authorize APRNs to prescribe medication and generally practice an expanded scope of care without direct physician supervision. The bill in its current form largely ignores months of negotiations between stakeholders to find a workable agreement and does not include any of the "compromise" language Gov. Evers proposed in his 2023-25 Biennial Budget bill. The legislation lacks common sense patient safety protections, including:

• Physician title protection that would prevent the use of specific words and terms in titles, advertising, and descriptions of services by medical professionals who are not physicians;

• An appropriate level of education and clinical experience required of APRNs prior to independent practice; and

• Requiring proper physician oversight of nurses who are providing pain management services.

In addition to the APRN bill,  Sen. Rachel Cabral-Guevara, who supports the ARPR proposal, has unveiled a separate physician title protection bill. The legislation would restrict individuals, except licensed physicians, from using certain words, terms, letters, or abbreviations that represent a person as a physician – and specifically applies those restrictions to a person's title, advertising, or description of services.

While the title protection bill – better known as truth in advertising legislation – is important and supported by the physician community, it is concerning that it was not included in the APRP bill as part of a greater compromise. The fear is that the Legislature could pass the APRN bill first and ultimately fail to approve the title protection bill.   

To best protect our members from potential political gamesmanship that could hang the physician community out to dry, the WAO is working closely with the Wisconsin Medical Society and other physician groups to oppose the APRN bill its current form and continue to work with lawmakers and other stakeholders on a workable compromise that includes robust physician title protection and other critical patient safety provisions.

From the Desk of WAO President David Nash, MD

For patients who need eye care, they quickly find out there are several different types of specials who work together to provide eye care, most notably ophthalmologists and optometrists. As you know, the difference between ophthalmology and optometry is a common source of patient confusion. That same confusion is also common among policymakers. A key reason for their confusion stems from the fact that optometrists are often referred to as eye doctors although they do not have medical degrees.

While we know ophthalmologists and optometrists frequently work together to effectively manage the long-term eye health and vision of patients, it is important for the public to recognize the difference in education and training between these eye care specialists. Education of both patients and policymakers is more important than ever as optometrists in Wisconsin and across the country continue efforts to expand their scope of practice to include laser eye surgery.

When it comes to tissues in the eye, we are talking about micrometers from one important tissue to the next. Ophthalmologists understand the room for error is small, and surgery on the eye is a specialized field of ophthalmology that requires years of advanced medical training and specialized equipment to perform. We also need policymakers in Madison to understand the concept of allowing an unqualified provider to shoot a laser in the eye is extremely troubling.

While optometrists are well-educated and critical to the collaborative eye care team, they are not trained to perform delicate surgical procedures, including laser surgeries. Optometrists can work alongside ophthalmologists to provide comprehensive eye care, including pre- and post-operative care for patients undergoing laser surgery, but they should not perform the procedure themselves.

As we watch other states across the country expand their optometric scope of practice laws to specifically include certain office-based laser procedures for glaucoma and post-cataract care, I am thankful the WAO has a robust government affairs program committed to securing policies at the state level that preserve patient safety and encourage the delivery of high-quality medical care.

The optometrist “scope creep” challenge we currently face is not likely to go away anytime soon, but the WAO is highly focused on the issue, and we will keep members update on any new developments.

Ophthalmologists are board certified medical doctors and surgeons who provide the highest quality of medical and surgical eye care for military veterans, and who are committed to maintaining the highest possible safety standards.

The Wisconsin Chapter of the Foundation for Fighting Blindness is holding the annual VisionWalk on May 21.  The event is located at Veteran’s Park at the Lagoon.  Registration opens at 9am and the walk begins at 10:30am.  Since its inception in the Spring of 2006, Vision Walk has raised over $63 million to fund sight-saving research.  Join the Wisconsin VisionWalk community; together we step closer to fighting blinding diseases.  Visit the event page for more information.

WAO is looking for experts in their fields to submit presentations to educate and inspire our attendees. Presentations will be accepted until Saturday, April 8. We estimate that all applicants will be notified of the status of their applications before the end of April.

Proposal selection is based on the following criteria:

• Originality of material
• Topic alignment with membership interest
• Timeliness of information
• Ease of implementing ideas presented
• Level of sophistication
• Specific learning objectives
• Practical application of materials
• Speaker qualifications

Learning Objectives:

Each abstract will need to include two to three concise and complete learning objectives that describe what the learner will be able to do at the conclusion of the session.

Please send questions to WAO@badgerbay.co.

SUBMIT HERE

With Wisconsin ophthalmologists facing a potential scope battle during the 2023-24 legislative session – as optometrists appear committed to expand their scope of services to include laser surgery – the WAO Government Affairs Team is keeping a close eye on Ophthalmology vs Optometry scope battles playing out in other states.

There are numerous states that have already expanded their optometric scope of practice laws to specifically include certain office-based laser procedures for glaucoma and post-cataract care. In addition, there are efforts currently underway in other states to pass similar optometric “scope creep” laws. Please find below a brief snapshot of what is happening with this growing threat to medical eye care across the country:

• South Dakota – The South Dakota Senate recently passed legislation (SB 87) – on a 26-9 vote – that would expand the  optometry practice scope in the state. More specifically, the legislation would authorize optometrists to perform laser surgery, including capsulotomy, peripheral iridotomy, selective laser trabeculoplasty, and corneal crosslinking. It would also allow ODs to administer injections around the eye, remove lid lesions, use a local anesthetic for lesion removal, and prescribe pharmaceutical agents. The bill is now under further consideration in the South Dakota House.
• Washington – In the state of Washington, a key senate committee recently passed legislation (SB 5389) that would authorize ODs to remove lumps and bumps from the eyelids, prescribe oral steroids, administer injections around the eye, and perform laser surgeries such as YAG capsulotomy and selective laser trabeculoplasty.
• Nebraska – A bill (LB 216) has been introduced and heard by a key committee in the Nebraska Legislature that would allow optometrists to perform selective laser trabeculoplasty (SLT) for the treatment of glaucoma.