Bureau of Occupational Licenses

1109 Main Street, Suite 220

Boise, ID 83702-5642 


Board Meeting Minutes of 5/30/2008




BOARD MEMBERS PRESENT:  Daniel L Tiller, O.D. - Chair

                                                             Michael R Flandro, O.D.

                                                             Francis Jerome Barnhart, O.D.

                                                             Donald Kenneth James, O.D.

                                                             Jack George Zarybnisky, O.D.



BUREAU STAFF:                           Tana Cory, Bureau Chief

                                                            Roger Hales, Administrative Attorney

                                                            Dave Hotchkiss, Investigations Coordinator

                                                            Carrie Gilstrap, Technical Records Specialist


OTHERS PRESENT:                     General Darrel Manning

                                                            Kris Ellis

                                                            Larry Benton

                                                Dr. Rob Sorensen, President of the I.O.P.


Meeting was called to order at 8:30 AM MDT by Daniel L Tiller, O.D.





A motion was made by Dr. Zarybnisky to approve the minutes of February 22, 2008 as written. Seconded by Dr. Barnhart, motion carried.




Ms. Cory presented the legislative update to the members of the Board.




Ms. Cory presented the financial report to the members of the Board.




Mr. Hotchkiss presented the investigative report to the members of the Board.


I-OPT-2006-2 A motion was made by Dr. Flandro to accept the Bureauís recommendation and authorize closure. Seconded by Dr. Barnhart, motion carried.


I-OPT-2007-3 A motion was made by Dr. James to accept the Bureauís recommendation and authorize closure. Seconded by Dr. Barnhart, motion carried.


Mr. Hales stated he did some research on the federal law regarding contact lens prescriptions. The Board discussed sending a postcard to licensees referencing the law. The federal law states the contact lens prescription must be valid for at least one year unless there is a medical condition to cause otherwise.


The Board discussed patients ordering contact lenses over the telephone or via the internet. The federal law states if a company calls the optometrist with an order, they have eight hours in which to respond before the company assumes the prescription is valid.






Dr. Tiller presented a response letter to Dr. Dammrose regarding the use of therapeutic lasers and billing insurance companies to the members of the Board.


A motion was made by Dr. Flandro to send the response letter as written. Seconded by Dr. James, motion carried.




A letter was received from ARBO requesting that each state submit a record of each licensee including their social security number, date of birth, licensure status, address, and license number for purposes of the OE Tracker database.


Discussion was held to determine if this was all a matter of public record. The letter stated there was a memorandum from the ARBO legal counsel which addresses this. The Board and Mr. Hales requested the secretary obtain this memo and present it during the next scheduled meeting.




General Manning provided the Board with a presentation on the role of a Board. The Board requested copies of the presentation for their own record. Dr. Tiller and the Board expressed their gratitude to General Manning stating it was very helpful. The Board also discussed the open meeting law. General Manning stated the Board needs to be very careful when there is a quorum in a social setting and to not make any decisions for the Board during such a time.


The Board would like to invite Mr. Bill VonTagan to the next meeting to discuss the state open meeting law in more detail. Dr. Tiller suggested putting copies of General Manningís PowerPoint presentation in the new Board member handbooks.






Dr. Rob Sorenson, President of the Idaho Optometric Association, approached the members of the Board. Dr. Sorenson discussed the history of the original CPT code letter that was addressed to third party payers. This was to help clarify what the scope of practice of optometry included. Dr. Sorenson stated he represents Idaho licensed optometrists, and as a group, they are worried the revised CPT code letter is shifting their scope. He added that he thinks the CPT code letter and its original intent has run its course and suggests another letter be sent retracting the CPT code letter all together.


Dr. Sorenson stated that if there is a letter which lists the codes, then he asks the letter include codes that are not allowed as opposed to those that are.


Dr. James stated he agrees with retracting the letter. Dr. James added that they were confronted by the Board of Medicine and, after meeting with their association to get their input, a second CPT code letter was sent out.


Dr. Sorenson stated his concern is the change of the intent of the letter, as it was addressed to licensed optometrists and not to third party payers. Dr. Barnhart asked if he knows if the average optometrist wants the letter to be rescinded. Dr. Sorenson stated he believes he represents the average optometrist and he feels the associationís board would back him up on the letter that was sent to the Board dated May 7, 2008. This letter was signed by him in regard to the association meeting and the CPT code letter asking it to be withdrawn.


Dr. Tiller stated he has doubts as to whether or not this letter was agreed upon by all members of the association and its board. Dr. Sorenson stated he feels he represents all of the licensees as President of the Association and they would agree with the letter he sent to the Board asking them to withdraw the codes letter. 


Mr. Hales stated he is interested in knowing where the association is on this issue. He added that the Board needs to focus on procedures and not on the specific codes, as this is the focus for insurance companies.


Dr. Tiller asked if an optometrist has a question on if they could perform a procedure or not, what would the Board say. Mr. Hales stated if asked a question about the procedure, the Board would have to go back to the law to determine this.  Dr. Tiller added the law would be easier to understand if it stated what they can not do as opposed to what they can do. 


Dr. Tiller asked Mr. Benton if he had anything to add to the discussion. Mr. Benton stated he appreciates the Boards membership and thinks the Board has a responsible job to do and they do it well.






The Board discussed the correspondence submitted by S. Kay Christensen, Deputy Attorney General, with an explanation of the legislative history for Idaho Code Section 54-1501. The Board discussed their ability to ask the Attorney Generalís Office for formal opinions, if needed.


Mr. Hales stated he was interested in the former justiceís opinion on the ďany meansĒ issue of the law and where the association is on that.




Dr. Barnhart stated the Optometry Board received a formal request from Dr. Sorenson asking to withdraw this letter and the Board should make a decision on this. Dr. James stated he feels that a majority of the licensed optometrists are not concerned with the letter. The Board discussed the concern that the Board of Medicine has had with the letter. Dr. Flandro stated he agrees with taking away the letter.


A motion was made by Dr. James to retract the current code letter and ask the Bureau staff to write a letter to the optometrists notifying them of the retraction and to include an explanation stating the optometrist can refer to the law if they have a question on providing procedures. Seconded by Dr. Zarybnisky, motion carried.




The Board discussed attendance to the annual ARBO meeting. Because of scheduling conflicts, there may not be anyone attending this year. Dr. James will check his schedule and may be able to attend. A motion was made by Dr. Zarybnisky to send one member to the ARBO meeting and to reimburse the expenses. Seconded by Dr. Barnhart, motion carried.




The Board received an e-mail correspondence asking if an optometrist can sign off for a technician like the medical doctors do. Mr. Hales stated that anything a technician does the optometrist is responsible for, just as lawyers are with their paralegals. Dr. Barnhart stated there is nothing in the law that says they can not. The Board requested the secretary contact the individual and get more specific information regarding his inquiry before a formal response is made.




Dr. Flandro stated he will respond to the letter submitted by Dr. Jerry Nave stating concerns over the CPT code letter.




A letter was sent to the Board from Dr. Morton Silverman, O.D., Diplomatic Public Health, stating there has been a long time concern over the lack of continuing education credits available for practice management courses in the various states.


The Board requested the secretary send a response thanking him for his letter, including the current rule on continuing education, and advising him that this state offers practice management sessions during the association meetings.




An inquiry from attorney Kim Stanger was submitted regarding his client who manufactures magnification equipment to assist with visually impaired persons and whether or not this client can enter into agreements with optometrists to make the equipment available to their patients. The attorney is asking if in the Boardís opinion whether or not his client would be violating in state law.


The Board reviewed their rules, specifically Rule 10.04 and their code of ethics. Dr. James stated he would have concerns if the optometrist made a referral to this individual and then received a kick-back from doing so.


A motion was made by Dr. Barnhart to direct counsel to correspond with the attorney and to state there is nothing in the law that would prevent his client from doing this. Seconded by Dr. Zarybnisky, motion carried.


The next meeting is scheduled for Friday August 29th, 2008 at 8:30 a.m.


The Board asked to have nominations of Chair and Vice Chair added to the next meeting agenda.



A motion was made by Dr. Zarybnisky to enter into executive session to discuss applications exempt from public disclosure as per Idaho Code 67-2345.1(d). Seconded by Dr. Flandro. Vote: Dr. Tiller, aye; Dr. Flandro, aye; Dr. Barnhart, aye; Dr. James, aye; and Dr. Zarybnisky, aye. Motion carried.


A motion was made by Dr. James to come out of executive session. Seconded by Dr. Zarybnisky. Vote: Dr. Tiller, aye; Dr. Flandro, aye; Dr. Barnhart, aye; Dr. James, aye; and Dr. Zarybnisky, aye. Motion carried.




A motion was made by Dr. Flandro to approve the following applications for endorsement. Seconded by Dr. Zarybnisky, motion carried.


ODP-100155  David Todd

ODP-100162  Dean Brown


The Board reviewed annual continuing education audits and signed wall certificates and meeting minutes.


The meeting adjourned at 12:30 p.m.