No significant fiscal implication to the State is anticipated.

The Optometry Board indicates that costs related to expert review of complaints as outlined by the bill cannot be determined at this time. If the number or complexity of associated complaints increases, the agency does not anticipate being able to absorb these expenses within existing appropriations and may be required to raise fees.

The bill would amend the Texas Optometry Act in the Occupations Code as it relates to the authorized scope of practice and the regulation of optometrists.

The bill would require the Texas Optometry Board (OB) and the Texas Medical Board (TMB) to collaboratively adopt rules for investigating complaints regarding treatment of a patient's glaucoma by a therapeutic optometrist. OB would be required to select Texas ophthalmologists to review glaucoma complaints and submit expert reports to an expert panel that would be established by the bill. The expert panel would be comprised of certain optometrists and ophthalmologists that are licensed in the state and would have the purpose of reviewing these complaints and issuing recommendations to OB regarding appropriate disciplinary action. 

OB would be required to maintain and make publicly available online information regarding the number of complaints filed with the board regarding the treatment of glaucoma and the disposition of the complaints along with a searchable list of each therapeutic optometrist whose certificate was suspended or revoked due to the mistreatment of glaucoma. 

The Optometry Board anticipates minimal costs for database upgrades and changes needed to track and post public information as required by the legislation that could be absorbed within existing resources. While noting that historically complaints regarding glaucoma treatment have been low, neither the Optometry Board nor the Texas Medical Board are able to anticipate the number of glaucoma treatment related complaints. They do anticipate costs associated with contracting expert reviewers, however. While TMB indicates that these costs could be absorbed within current resources, OB does not anticipate having sufficient appropriations to address additional expenses. OB's ability to pay expert reviewers will directly impact its ability to carry out the requirements of the bill.