Winding Down

I will begin by restating what an honor and a pleasure it has been to be elected and serve as your POA president during 2011. I had the good fortune of learning about this association by watching and befriending the very best leaders we have ever had. We have weathered national issues such as health care reform, board certification and Medicaid parity, and many state issues such as changing technology, managed care organizations, and several versions of anti-optometry legislation.

I do need to draw your attention to a bill that is pro-optometry in the Pennsylvania Senate right now. Senators Pippy, Rafferty and Don White introduced this session’s Unfair Insurance Practice Act (SB 939). Other sponsors include Senators Fontana, Ferlo, Brewster and Farnese. This bill, although it has been amended from its original form, is still very positive for optometry and our patients. If passed, it would eliminate a benefit plan mandating the use of a specific lab for ophthalmic products and services. It would stop any assessment of a fee or copayment if a non-required lab is used. It would prevent the creation of preferred classes of providers not held to uniform conditions of participation. Finally, the amended version still contains a prohibition on requiring a provider to participate in a vision benefit plan as a condition of participation in a health care plan. SB 939 passed out of the Senate Banking and Insurance Committee 14-0 and has been referred to the Senate Appropriations Committee. Incidentally, Representative Harry Readshaw introduced the same bill in the House of Representatives, but HB 929 has gotten less attention so far. Please get behind these bills and contact your legislators regarding SB 939 and HB 929. Explain to them how these bills benefit our patients (their constituents) and our profession.

In addition to our legislative issues, we have a lot of other activity at the POA.  Dr. Donna Buraczewski, your POA president for 2012, recently held her planning session for next year. It was very productive and set the stage for the final year of our current three-year Strategic Plan. All uncompleted objectives were given action plans in this final year. I am very excited and looking forward to serving under Dr. Buraczewski and President-elect Dr. Bob Owens.

As I look forward, I also want to take a moment to look back. I want to thank three people directly responsible for my professional success – the two POA presidents before me and our executive director. Dr. Bob Bittel, Dr. Greg Caldwell and Dr. Charlie Stuckey have given me the support and friendship I needed to lead this association this year. We had a bumpy road at times and were dealt some bad hands, but we always acted with the best interest of our membership first in our minds.

I want to thank the unmentioned remainder of the POA Board of Directors: Dr. Marianne Boltz, Dr. Rich Christoph, Dr. Mark Margolies and incoming Board member Dr. Steve Eiss. Remember these names, as they will continue the tradition of great leadership in the years to come. I will join in supporting every one of them. These are all good, smart people and dedicated volunteer leaders! They will all learn how valuable the POA staff can be. I know, but if I mention them each by name they will edit that out before printing this. (Editor’s note: true.) They are great people who work tirelessly to support us and make us look good. To the rest of my colleagues – thank you again for lending me your ear this year with this forum and for all of the support and willingness to help when called upon.

Finally, I want to thank my wife, Danielle, and our three children – Sarah, Jake and Tommy who range in age from twelve to five.  I have either missed (or dragged you along to) many things in the past six years to do this job effectively, and I appreciate that it has been hardest on you!  I love you all!

Daniel F. Russell, O.D.
President
Pennsylvania Optometric Association
http://www.poaeyes.org/

Optometry at the Capitol Day a Success

It is amazing what can be accomplished when we all work together. A collaboration of 170 optometrists and students, in addition to several paraoptometrics and POA staff, helped make Optometry at the Capitol Day a big success.

We kicked off the day with a grassroots advocacy program focused on visiting with legislators and raising money for PAC. Presenting were Brian Reuwer (AOA legislative staff, Washington office), Dr. Bobby Jarrell (AOA State Government Relations Committee chair, from New Mexico) and Dr. Bill Reynolds (Legislative Affairs Committee chair, Kentucky Optometric Association). They presented information on the “dos and don’ts” of interacting with legislators. In addition, they provided strategies for getting more comfortable with your legislator and how to grow and maximize that relationship.

I addressed the group with our new Legislative Affairs Committee chair, Dr. Bob Bittel, to provide some history on HB 838 and its predecessors in the Pennsylvania House of Representatives. We were able to introduce the newest members of our lobbying team, the firm of Long, Nyquist & Associates. They have already proven effective in strengthening relationships with Senate leadership.

We also featured a guest speaker – Senator John Gordner, vice chair of the Senate Consumer Protection and Professional Licensure Committee. He has been a supporter of organized optometry and our issues for many years. He shared some personal stories as he looked out into the audience and located his optometrist, Dr. Bob Albertson. Senator Gordner also made some remarks about how we can most effectively support our legislators as we oppose HB 838.

Another focus of the day was expanding our grassroots efforts by strengthening our keyperson system. Definition of ophthalmic surgery legislation has gotten further this session in the legislative process and has begun to awaken the sleeping giant that is our keyperson system. We spent a great deal of time pairing experienced optometrists with both new graduates and PCO students in an effort to develop our keyperson mentorship program. We even saw a number of constituent optometrists step up in the absence of some keypeople and lead these group visits in Senators’ offices. It was great to see some established and newly-developing leaders advocating on behalf of optometry and the citizens of Pennsylvania.

We also had a number of presentations regarding POPAC. We had several new POPAC contributors in addition to having many people increase their level of giving. I would encourage you to review your current level of PAC giving and to increase to the next level as you are able. I would also like to thank our immediate past president, Dr. Greg Caldwell, for leading the POPAC push among the members of the audience. He was able to raise a very significant amount of money in that room in only two hours.

Finally, I would like to thank everyone involved in Optometry at the Capitol Day: the POA Board of Directors, each of whom had a role; the POA staff, who put an enormous amount of effort into coordinating each visit for the optometrists and students; PCO and its administrators, for transporting 85 students to Harrisburg and excusing them from clinic and other educational activities so they could participate in this critically important event; our lobbying team, for everything they are doing on behalf of optometry; and last but not least, all of the optometrists who closed their offices and came to Harrisburg to join together to advocate on our behalf.

Thanks again for the honor of being your POA president and for lending me your ear.

Daniel F. Russell, O.D.
President
Pennsylvania Optometric Association

http://www.poaeyes.org/

What have you been up to?

In addition to constant POA and AOA activity, coaching my kids’ teams and enjoying the play of the Pittsburgh Pirates for the first time in almost twenty years, I have sprinkled in some patient care this summer. I know many of you have been just as busy because I have fielded many questions about the outcome of the POA and AOA Annual Meetings and special sessions from colleagues who were not able to attend. I want to provide a mid-term State of the Association for you and review some of the things you may have missed.

The POA Congress with the Annual House of Delegates in State College in May was a success. We had broad representation of the local societies and a productive House. I would like to thank Dr. John Alexander, chair, and his Resolutions and By-Laws Committee for their work. One duty of this committee is to periodically review old resolutions. From this review, I was directed to set up a committee to review the association’s Code of Ethics. This committee has been chosen, the members are being invited to participate and their report will be presented at the 2012 POA House of Delegates in Bedford Springs.

We also had a great presentation from the Ad-Hoc Committee to study POA Voting at the AOA House of Delegates – thank you to Drs. Tony Diecidue, chair, Bob Bittel, Scott Goldberg and Harvey Hanlen. Their presentation sparked discussion and provided clarity regarding the membership’s representation from the individual through the local society, the POA and on to the AOA. The committee’s PowerPoint presentation is now available on POA’s website in the About the POA section for your review.

Under Open Microphone, Dr. Jim Paulson provided a legislative update and a lengthy discussion ensued – thank you to Jim and his committee. There has been significant activity on HB 838 since Dr. Paulson’s report, and I encourage you to visit POA’s Legislative Priorities page regularly to be kept up-to-date.

In addition, I would like to thank Secretary/Treasurer Dr. Mark Margolies for his work with Joyce from the POA office regarding the 2012 budget. It was presented, discussed and adopted. We also considered the recommendations of the Nominating and Evaluating Committee for the slate of officers for 2012. As a result, elections were held and the Board of Directors is set for next year – thank you Dr. Diecidue and your N&E Committee.

Finally, we had a nice presentation from our AOA Board of Trustees representative. Thank you again to Dr. Sam Pierce for attending and participating in our meeting and for enduring the golf outing with Charlie and me. We had significant rain and that’s what I’m blaming my performance on!

I also had the pleasure of spending five days in Salt Lake City, Utah, for Optometry’s Meeting. It is a very clean city with good public transportation, great hotels and warm June weather with beautiful snow-capped mountains in every direction.

In addition to elite continuing education, a great exhibit hall and top-notch entertainment and friends, we also had a very productive AOA House of Delegates. There were a total of fourteen resolutions submitted for consideration by the Resolutions Committee. Seven of them were withdrawn by their sponsor, including Resolutions B (Optometric Education Curriculum), C (Access to Vision Care for Children), E (NBEO Clinical Skills Exam Testing Site), I (Candidate Status for ABO), J (Affiliate Legal and Defense Fund), K (Evaluate Workforce Statistics) and M (Initial Requirements for ABO). Five Resolutions were passed by vote on the House floor, including Resolutions A (Affiliate Legal and Defense Fund), D (APHA Membership), H (Vision Care for Children), L (Licensure Renewal) and N (Healthy People 2020). Two resolutions were defeated on the House floor including Resolutions F (Feasibility Study of Membership Voting) and G (Support for ABO). Please take the time to review what occurred in greater detail via AOA’s website.

There was also a substantive motion that was made from the House floor regarding accreditation of providers of continuing education instead of individual courses. It was discussed and tabled on Friday and reconsidered on Saturday. It passed as amended and there will be a presentation at the 2012 House in Chicago, Illinois.

Finally, I would like to thank the individual members who actively fought against HB 838 in the House of Representatives. We lost this vote in the House and need your participation to defeat this predatory legislation in the Senate. Please refer to the other articles in this Keystoner regarding HB 838, contact your Senator, give additional money to POPAC and attend Optometry at the Capitol Day. It will require all of our efforts to defeat this bill. Thanks again for the absolute privilege of being your president and for lending me your ear.

Daniel F. Russell, O.D.
President
Pennsylvania Optometric Association

http://www.poaeyes.org/

AOA Congressional Advocacy Conference update

I had the honor and the pleasure of joining Dr. Mamie Chan of New Mexico and Dr. Max Ernst of Kentucky in co-chairing the 2011 AOA Congressional Advocacy Conference in Washington, D.C. You should be proud of the group of volunteer leaders that made up the Pennsylvania delegation as well as the outstanding group of students representing our Commonwealth. We had eight optometrists and thirteen students in our group and were able to effectively advocate on optometry’s behalf.

With the mid-term election shift that occurred in both the House of Representatives and Senate, there are many new relationships to be built and opportunities to be seized in Washington. When I visited Senator Pat Toomey’s office, for example, he was located in the basement between two Senate buildings as he hadn’t been assigned an office yet. It was a pleasant visit and because we didn’t have a specific “ask” or any legislation in the Senate right now, it was the perfect time to start a relationship with Senator Toomey. With this shift in power from one side of the aisle to the other comes great uncertainty with regards to health care reform. The message we received was consistent and clear – when all the discussion is over and the dust clears, there will be at least some aspects of health care reform that remain. Regardless of your political views, we have to ensure that optometry is properly positioned for inclusion in the new health care model.

This brings me to the first piece of bi-partisan legislation that we support. HR 1219 is the Hall-Schakowsky Optometric Equity in Medicaid Act. As you may know, Doctors of Optometry have been formally recognized as physicians in Medicare since 1986. Unfortunately, Medicaid fails to fully recognize optometrists as the primary eye health and vision care providers that we are. This presents a major access problem as we know that the bulk of the newly-covered citizens under the state Insurance Exchanges will come in through the Medicaid program. In addition, studies show that there are 3,500 communities across this country where optometrists are the only eye doctors.

The second piece of bi-partisan legislation we support is HR 1195, the National Health Service Corps (NHSC) Improvement Act. Optometry is currently excluded from participating in some federal health programs like the NHSC. Approximately 11% of NHSC community health center facilities have eye care in the impoverished or underserved areas in which they are located. Again, this is another problem with access to care. The program through the NHSC allows health care providers to work in an underserved area in exchange for debt relief dollars but optometrists were not included in the 2002 restructuring of this program. This change would not require any new federal spending, it would simply allow our debt-ridden graduates to compete for debt-relief dollars that already fund that program and put primary eye care in additional NHSC facilities.

So check out the link below to see some of the highlights of the AOA Congressional Advocacy Conference and know that the present and future volunteer leaders in Pennsylvania are advocating on your behalf. Thanks.

www.youtube.com/watch?v=AUxtFabucM0&feature=youtube_gdata_player

Daniel F. Russell, O.D.
President
Pennsylvania Optometric Association

http://www.poaeyes.org/

After 13 years, small dues increase necessary to balance POA’s budget

We spend either a great deal of time or a great deal of money keeping our books or having someone keep them for us. We have office managers, accountants or tax advisors at a minimum. That is unless we take on the impossible task of paying bills, paying staff and monitoring things like fixed costs and cost of goods between patients and in our "free" time.

I want you to know, or remind you, that we have the very best people in place at the POA office to "keep" our professional association’s books for us as well. The staff and volunteer leaders we have in place to budget our money and manage our programming are second to none. They were tasked with designing a budget for the 2012 calendar year very early in 2011. While obviously difficult, they have historically done a great job at projecting income and expenses, sometimes eighteen to twenty months in advance. The reality of it is that we have ended some fiscal years in the black and some in the red. This has enabled us to propose twelve straight dues-neutral budgets to the POA House of Delegates.

Despite priding ourselves in being fiscally responsible, we have ended the past two years with meaningful deficits. This has been due to a combination of an increase in costs, a decrease in dues income and a decrease in non-dues income as well. We have all felt the increase in operating costs over the past twelve years – there is no mystery there. Our dues income has been falling despite our membership numbers holding steady. How can that be? We have seen an increase in the number of "Life" members as the AOA (2007), and subsequently the POA (2008), made changes in by-laws lowering the age requirement for Life membership by 10 years, which increases our number of non-dues paying members. We have also seen a shift in membership to "Partial Practice" and other less-than-full dues categories. All of these changes have resulted in a decrease in the amount of our dues income.

Surprisingly, our budget is only about 55% dues revenue with the balance coming from our non-dues income. We have also seen a decrease, or at least a lack of growth, in non-dues income. We have fewer people participating in POA programming and revenue-generating activities.

The results: a proposed 2012 budget at the 2011 House of Delegates in State College that has a small dues increase. We have concentrated in the past on controlling programming expenses and keeping dues rates flat but this has not allowed us to cover increases in operating expenses. The hope is that this small increase will also allow for development and expansion of some POA programming that had been impossible in the past. Our goal is ultimately to serve you, our membership, and to provide you with the highest level of programming and advocacy. So review the proposed budget for 2012 on page 4 of the April Keystoner and attend our May 2011 POA House of Delegates in State College. See you there and, again, thanks for your ear.

Daniel F. Russell, O.D.
President
Pennsylvania Optometric Association

http://www.poaeyes.org/

A pat on the back and a call for action

I recently attended AOA’s President’s Council in St. Louis and today there are three things that are certain. One, Pennsylvania optometry and the POA are behind other state affiliates in legislative affairs and scope of practice issues. Two, we are still on the leading edge in most other areas including Third Party Center issues. Third, I am still in mourning over the outcome of Super Bowl XLV so I will be concentrating on the first two certainties for the remainder of this piece.

After lengthy discussion with other states’ volunteer leaders and executive directors, I find the POA is often in the position of getting advice from other state affiliates regarding scope of practice and legislative issues. The AOA is well aware of where we stand with our legislative battles as we are their fifth largest state affiliate. We often have conversations about how we can further our legislative agenda and protect ourselves from others whose agendas can affect us. Many of those conversations center around language that can help us.

Unfortunately, like the last legislative session, we again have to defend our ability to practice against a predatory bill that is being reintroduced. Organized ophthalmology has a primary sponsor for a “Definition of Ophthalmic Surgery” bill that, if the language is similar to last session’s bill, can affect us greatly. It will halt any future scope advances we will need as technology and standard of care evolves, and has the potential to limit some of the procedures we have fought so hard for in the past. Defining ophthalmic surgery in the Medical Practice Act is unnecessary. Our Optometric Practice Act specifically states under Section 2 that the “Practice of Optometry shall not include … surgery, including, but not limited to, laser surgery; the use of lasers for therapeutic purposes …” So please, get out and spread the word – contact your legislators and ask them not to cosponsor this predatory and unnecessary bill.

The flip side is that POA is often in the position of giving advice to other state affiliates regarding other issues. The Electronic Claims Service we have at the POA office is the only one of its kind. It gives us a source of non-dues income, allows us to be in constant touch with the specifics of reimbursement and gives an ongoing source of feedback when our members have issues with payers. We can then add those issues to the agendas for the Optometric Advisory Committees (OAC). Other states believe they have good relationships with their third party payers but none have the personal relationships with the number of major payers as Pennsylvania.

I was also able to present our developing webinar concept to the other state affiliates and was approached by several colleagues with inquiries afterward. Others have thought about the concept but have not pursued it any further. When we are successful with the webinar for COPE-approved CE, we can serve as a model for others wanting to do the same.

I also discussed our Podiatry/Pharmacy/Optometry/Dentistry (PPOD) initiative that has evolved through our Pennsylvania Diabetic Eye Health Alliance. We strive to provide the most efficient and complete care for our diabetic patients and share information with other specialties. This program benefits both the patient and the practitioner. We have also presented it through our OACs so the third party payer can see some benefit from this as well.

I think it’s very important to evaluate your strengths and weaknesses. That being said, I think our pat on the back should be brief and we should focus on our weaknesses. We have a very big challenge right now to protect our association and our ability to make a living. The legislative issues we face right now are huge and have long standing consequences. I will close by again rallying the troops and calling you to action. Please visit your legislator and use the POA talking points on our website so we can present a consistent and unified message. Increase your giving to POPAC and support the POA and local societies in whatever way suits you best. Let’s keep our eye on the big issues and not lose ourselves in the smaller stuff. Thank you again for the honor and privilege of being your president and lending me your ear.

Daniel F. Russell, O.D.
President
Pennsylvania Optometric Association

http://www.poaeyes.org/

Let's be Friends

This summer will mark twelve years of practice for me. In getting a bit nostalgic, I am not pretending to remember the "good old days" of Optometry. I know nothing other than the modern world of third-party vision and medical benefit plans. But I do remember the days of having your practice's phone number in the phone book simply so our patients can call us if they lose their reminder card - though it appears those days are over.

Don't get me wrong, I am not advocating for, nor will I speak out against, advertising. A portion of our membership still resists the idea of advertising for various reasons. However, according to my very un-scientific perception of things, many of our members have embraced the concept of practice promotion. We see many ads in the yellow pages, in the newspaper and on television. The problem with relying only on this type of community interaction is that many people are getting their news and information in other ways.

We must realize that many of our patients, especially younger generations, are relying on various forms of social media for their information. These new technologies have given people new ways to communicate information and ideas.

Our Pennsylvania Optometric Association has embraced these new opportunities and we are now on both Facebook and Twitter. If you haven't already joined us, you can find us on Facebook at www.facebook.com/PennsylvaniaOptometricAssociation and follow us at http://twitter.com/poaeyes# on Twitter.

I admit that I have resisted these forms of social media in the past. It may be because I have a bit of my father in me -- he boasts about being the last person on the planet to have bought a VCR. The only reason he owns a desktop computer and DVD player is because he benefits from hand-me-downs from my sisters and me. I have also tried to justify avoiding forms of social media because I spend all day at the computer with the EHRs we have at the VA Medical Center and had little interest in extra computer use at home.

On the other hand, my wife loves to post and view pictures of the kids and share them with friends and family on Facebook. She Instant Messages her friends and enjoys her time online. She has convinced me to take the leap -- I aspire to create a Facebook page and, hopefully by the time you read this editorial, I will be welcoming and soliciting friends and, of course, "Liking" my professional association. 

As part of the POA's commitment to technology, we are offering a completely new type of CE program -- a webinar. On February 4, POA offered its first live webinar for COPE-approved Glaucoma CE credit, which is now available 24 hours a day, seven days a week. I hope you will join me in taking advantage of this low-cost member benefit. As you have heard your POA leadership say numerous times, supporting the POA's sources of non-dues income is imperative. We believe this webinar is a great opportunity for you to do just that while earning the CE credit you need with the convenience you want.

Join me in the commitment to advance with technology - using it not only to provide the best of care in our offices, but also to provide information in our communities.

And speaking of technology, POA included a short technology survey in the February Keystoner and the President's Editorial and Member Bulletin e-mail that was sent to members on February 15. The survey is designed to determine our technology needs so POA can help us meet our goals. I ask that you return the survey from the Keystoner or simply hit REPLY to the President's Editorial e-mail, type an "X" in front of your answers and send your feedback to POA. Thanks in advance for your participation.

Daniel F. Russell, O.D.

President,

Pennsylvania Optometric Association

http://www.poaeyes.org/