The House passed House Bill 36, which amends the Optometry Act to allow credentialed optometrists to perform specified in-office procedures, after floor debate about training, oversight and access in rural areas. The bill requires the Optometry Board to set credentialing requirements for optometrists who wish to perform the procedures.

Representative Hockman B. Hill, presenting the bill, said the change "would allow optometrists to do procedures that ophthalmologists would normally do," and argued the measure will increase access to care, particularly in rural New Mexico.

Nut graf: Supporters said the bill expands patient options and reduces wait times in under-served areas; opponents and some members urged caution on training standards, malpractice reporting and whether scope expansion should be limited geographically or accompanied by additional oversight.

What the bill does

- Scope expansion: The bill amends the Optometry Act to include several types of in-office procedures. The text excludes interior chamber paracentesis procedures and intraocular sustained-release drug-implant replacement from the expanded authority and directs the optometry board to establish credentialing requirements for optometrists who wish to perform the newly authorized procedures.

- Credentialing and training: Sponsors said optometry students already receive months or years of didactic and hands-on training relevant to these procedures and that credentialing under the bill would add a supplemental course. On the floor, the sponsor stated, "studies show no increased complication rates for optometrists performing these types of procedures as compared to ophthalmologists." The transcript records a description that optometry programs include labs and hands-on laser training in the fourth year of school and that a 32-hour supplemental course was discussed in the bill's context.

Floor debate and concerns

- Training differences: Several members contrasted optometrists' and ophthalmologists' training. A member summarized the distinction: ophthalmologists attend medical school and residency, while optometrists complete optometry school; debate included differing characterizations of residency hours and the point that ophthalmologists' residency training focuses on surgical care.

- Safety and outcomes data: Supporters pointed to state experiences in the 12 states that currently permit optometrists to perform similar procedures and said the available data show low complication rates. Opponents noted much of the reporting is collected by optometry boards rather than medical boards and urged caution about relying solely on those data.

- Malpractice and oversight: Members asked whether malpractice insurance premiums would rise and who would collect and review adverse-event reports. The sponsor responded that other states have not seen higher malpractice insurance premiums where optometrists perform these procedures and that a board would be responsible for guardrails and data collection.

- Rural access and a withdrawn amendment: Representative Armstrong moved House Amendment 231261.1 to limit implementation to Class B counties (described on the floor as excluding Bernalillo, Dona Ana, Sandoval, San Juan, Santa Fe and Los Alamos counties). After discussion noting the potential for unintended exclusions of rural and tribal areas within some counties, the sponsor withdrew the amendment, citing the intent to expand access in rural New Mexico.

Procedure and outcome

Representative Hockman B. Hill moved final passage. The House passed House Bill 36, as amended on the floor, by a recorded vote of 56 in favor and 7 opposed.

Clarifying numeric and procedural details

- Amendment: House Amendment 231261.1 (limit to Class B counties) was offered and later withdrawn by its sponsor on the floor; the amendment text clarified that it would have limited the bill to counties classified as Class B under state law (a classification list was read on the floor).

- Training description: On the floor members said optometry students receive extensive training during their degree program, including didactic courses, labs and hands-on laser training; supporters emphasized that the supplemental credentialing in the bill is in addition to several years of existing training.

- State examples: Members cited 12 states that already permit these procedures by optometrists, including Colorado, Wyoming, Oklahoma and others.

Next steps and implementation

The bill directs the Optometry Board to promulgate credentialing requirements and reporting mechanisms. Members who raised oversight concerns said they expect the board’s rules and any reporting to clarify scope, training standards and outcome tracking once the board begins rulemaking.