AOA Advocacy Toolkit

Scope of Optometric Practice Legislation

May 2019

For more information, please contactDaniel Carey

Director of State Government RelationsDcarey@aoa.org

American Optometric Association

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Table of Contents

Letter from AOA President………………………………………………………………………..4

Introduction & Overview…………………………………………………………………………..5

Eye and Vision Care Access Nationwide ……………………………………………………6

Advocating for Legislation: Getting Started……………………………………………….8

Engaging with Your Legislator……………………………………………………………………10

Tips to Advocate for Your Legislation…………………………………………………………12

Sample Q&A from Legislators ……………………………………………………………….…..15

AOA Model Legislation……………………………………………………………………………….16

AOA SGRC Best Practices for Political Advocacy………………………………………….19

Advocacy Tools

Key Messages/Talking Points………………………………………………………….22

Scope of Practice Enactment Timeline ……………………………..…25

Scope of Practice Laws Statewide……………………………………….28

Scope Map Chart ……………………………………………………………….29

Scope Map………………………………………………………………………….30

Communications Tools

Overview & Recommendations…………………………………………………….33

Letter to Lawmakers Template……………………………………………………..35

Media Interview Tips…………………………………………………………………….37

Sample Media Pitch………………………………………………………………………39

Opinion Editorial How-to-Guide……………………………………………………40

Opinion Editorial Template…………………………………………………………42

Social Media Best Practices…………………………………………………………44

Sample Social Media Messages……………………………………………………48

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Letter from the President

Each day, I feel a sense of pride in being able to provide essential eye health care to patients and maximize what is universally recognized as the most precious sense—sight. I know how hard the profession of optometry has fought to get to this point.

I vividly remember the frustration I felt when, less than three decades ago, I couldn’t perform corneal foreign body removal or lacrimal dilation and punctal plugs because it was illegal in the state of Alabama. While optometry’s strides during the past 40 years have been remarkable, the need to continue this path is no less compelling today.

The unregulated, contemporary practice of optometry is only currently recognized in a handful of states, and there’s still a tremendous amount of work to be done in updating legislation to meet the modern education and training of doctors of optometry. There are too many procedures that we should be able to offer to our patients but can't because of antiquated laws.

We are taking assertive steps to support efforts to expand the scope of practice across states and to drive awareness of the vital care doctors of optometry provide—care that takes just as much skill and expertise as any other medical specialty. This is especially important in today’s climate where we face unprecedented obstacles that threaten the future of the profession and patient care on multiple fronts.

Through these efforts, we want policymakers and the public to fully recognize optometry’s essential and expanding role in the health care system, and place patient eye health and safety at the center of the nation’s health care agenda with doctors of optometry at the frontline.

The AOA stands at the ready to assist your state, from evaluating where you are, to determining where you need to be with your legislation. We are committed to uniting together to advocate for change and for the future of our profession.

Please use these tools to help prepare yourselves and educate your lawmakers as you plan to introduce scope expansion legislation.

Sincerely,

Samuel D. Pierce

President of The American Optometric Association

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Overview & Introduction

Doctors of optometry deliver an essential component of patients’ overall health and provide more than two-thirds of primary eye health care in America. More than 99 percent of the U.S. population lives in counties with a doctor of optometry. In more than 5,800 communities nationwide, doctors of optometry are the only primary eye and vision care providers.

The AOA is dedicated to ensuring doctors of optometry can practice to the highest level of medical eye care and patients have access to the primary eye health care they provide across the country. To enhance that access, the AOA is taking assertive steps to support states in expanding optometry’s scope of practice and ensuring doctors can practice to the full extent of their education and training.

This toolkit is intended to assist state associations in preparing to address scope expansion. With the definition of scope varying across the nation, communicating the different nuances can be just as complicated as the legislation. The tools and resources provided here will help states navigate the current political and legislative landscape, as well as engage with lawmakers, the media and other key audiences. In all cases, advocates are encouraged to modify the materials as needed, particularly to reflect aspects of the legislation that are unique to their state.

We hope the information provided here will help bolster your insights as you strategize and develop a plan for victory in redefining what it means to be a doctor of optometry in your state! Questions should be directed to Daniel Carey, AOA’s Director of State Government Relations, at Dcarey@aoa.org.

**Please note these materials (except for the fact sheets) and are for internal reference/use only.

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Eye and Vision Care Access Nationwide

At a time when patients are facing a potential lack of access to primary care, doctors of optometry are uniquely positioned to serve as frontline providers in primary eye care for the vast majority of U.S. patients.

Research conducted by the American Optometric Association (AOA) shows 46,521 doctors of optometry are providing patient care in the United States.1 As of February 2018, doctors of optometry practiced in more than 10,176 communities, and counties that account for 99 percent of the U.S. population.2 Thirty-nine percent of U.S. counties or county equivalents (representing 8 percent of the U.S. population or 24.9 million individuals) have access to an optometrist but not an ophthalmologist.3 Ninety-one percent of the population are living in a county with access to both types of eye doctors.

In a letter4 to the lawmakers in the state of Washington, the Federal Trade Commission (FTC) cited a 2015 article by Diane M. Gibson published in Preventative Medicine stating that 24 percent of U.S. counties had no optometrist or ophthalmologist. However, the AOA Health Policy Institute (HPI), using accurate and updated data, found only 12 percent of counties or county equivalents in the U.S. (accounting for 1 percent of the U.S. population or 3 million individuals) do not have eye doctors.

Gibson's article used 2011 data from The Area Health Resources File (AHRF) to determine the number and practice location for both optometrists and ophthalmologists.5 The source of ophthalmology data in the AHRF was the American Medical Association's (AMA) Physician Masterfile. The source of optometrist data in the AHRF was the Centers for Medicare and Medicaid Services National Provider Identification (NPI) File and not that of the AOA's Data Management System nor data from the State Boards of Optometry License Files. Doctors of optometry in the NPI data file were listed with one office address only. AOA data show that roughly 15 percent of practicing optometrists work in more than one location. When considering access to eye care based on the number of eye doctors in a county, policymakers should be aware of the limitations of some data that may lead to inaccurate assumptions.

The AOA HPI performed a new analysis using more complete data, including data on practicing optometrists obtained from the AOA Master Optometry List. This data includes multiple practice location zip codes for current licensed, practicing optometrists in the U.S. Data for ophthalmology

1 American Optometric Association (AOA) Professional Optometrist Data. St. Louis, Missouri. February 22, 2018.2 U.S. Census Bureau. 2010 ZCTA to County Relationship File. https://www2.census.gov/geo/docs/maps

data/data/rel/zcta county rel 10.txt. Accessed March 1, 2018.3 American Medical Association (AMA) Masterfile Physician Professional Data 2016. Chicago, Illinois. Available from: Medical Marketing Services, Inc. October 2017.4 https://www.ftc.gov/system/files/documents/advocacy_documents/ftc-staff-comment-washington-state-rep-paul-graves-regarding-ssb-5411/hb-1473/proposed_advocacy_comment_-_wa_eye_care_final_2-9-18.pdf5 Gibson, D.M. (2015) The geographic distribution of eye care providers in the United States: Implications for a national strategy to improve vision health, 73 PREVENTIVE MEDICINE. 30.

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were obtained using the AMA Physician Masterfile and include the primary practice zip code for each ophthalmologist. Zip codes from the optometrist data for all known practice locations and for the primary ophthalmologist locations were matched to U.S. Census Bureau data to determine counties in which there were eye care providers. The number of practice locations for both optometrists and ophthalmologists might be incomplete and access to eye care providers may be higher than estimated in this brief.

Only 17 counties, distributed across 10 states, have populations greater than 20,000 with no doctor of optometry or ophthalmology. Only 5 counties within 4 states have populations greater 25,000 and no eye care provider (See Table 1). When considering access to eye care based on the number of eye doctors in a county, policymakers should use these more accurate and updated data.

Credit: Health Policy Institute (HPI)/American Optometric Association (AOA)

Among the 10 largest counties in the U.S., all but one (Kings County, New York) have 20 or more eye care providers per 100,000 population.

Sixty percent of U.S. counties or county equivalents (1,883 counties or equivalents) have more than 50 percent of total population represented by rural population.6 Eighteen percent of these counties or county equivalents (accounting for 675,610 rural population or 1 percent of the total rural population in U.S.) have no eye care provider. Doctors of optometry are practicing in the remaining 82 percent of counties or county equivalents where a majority of the population is rural. Ophthalmologists are practicing in 31 percent of these counties or county equivalents.Geographic access to eye care is not an issue for the overwhelming majority of the U.S. population, including the rural population. Optometrists are currently practicing in counties and county equivalents that comprise 99 percent of the total population in both urban and rural areas.

6 Gibson, D.M. (2015) The geographic distribution of eye care providers in the United States: Implications for a national strategy to improve vision health, 73 PREVENTIVE MEDICINE. 30.

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Getting Started: Advocating for Legislation

Legislator/Candidate involvement

Establishing a relationship with a legislator can seem like a daunting task, but the importance of these relationships cannot be stressed enough. Your success will be built on these relationships.

You are guaranteed nothing more than an open door and a conversation Treat these relationships with the respect and attention they deserve Your success depends on it now and into the future

Getting to Know Your Legislator/Candidate

In the legislative world, especially among advocates of any kind, your word is your most valued resource. Above anything, never compromise the trust a legislator has in your expertise by compromising the information provided simply to gain a short-term victory. Always be truthful and honest, no matter what.

To the elected official, you are the expert and their source for accurate information on issues relating to optometry. These legislators look to you to give them the information they need and can count on.

“See you at the…”

There are a multitude of ways you can get to know your legislator or candidate for public office. Below is a list of examples which continue to be effective:

Fundraisers Private Meetings Campaigning Legislative Meetings Day at the Capitol Town Hall Meetings Casual Get Together Caucus and State Political Party Events

Grassroots Efforts—Campaign with a Candidate

Get involved in a political campaign:

Door to door delivery of campaign literature Help with campaign mailers (i.e., stuffing envelopes) Host a fundraiser

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Encourage friends and family members to support the candidate through emails, Facebook, Twitter, and phone calls

Make phone calls during campaign phone bank hours Volunteer at a fundraiser you are not hosting Walk in parades and other public gatherings Attend election night events

Grassroots Efforts—The Keyperson Network

Be sure each keyperson fully understands what is involved Outline expectations and hold them accountable Involve them during your “Day at the Capitol” so they can learn the ropes of the process

and continue to grow comfortable in this role Educate them as to why a keyperson is necessary Keep them engaged throughout the year Instill in them they must always be courteous and respectful, no matter the situation,

this is key to long term success

Grassroots Efforts – Strategy

Develop talking points and a solid foundation as to why your legislation is necessary o DO NOT deviate from the core points, but personalize them and make them

conversational o You want to talk with your audience, not at them

Your lobbyist is your legislative expert and your eyes and ears on the ground. Use them as a sounding board to make the key decisions

Stay personally informed as to what is going on during and out of session, as well as during elections

Knowing the process of the legislature will help you to forecast the movement of a billo Always stay a few moves ahead of the other guys

Stay calm and see the end game o Things can change rapidly during a session, but you’re prepared and ready for

this challenge

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Engaging with Your Legislator

Start at the BeginningWhen you have legislation to talk about, your legislator should know who you are.

Find out who your state Senator and state Representative are. This can be done by visiting the state legislative website or by communicating with your state association.

- Home address (primary), office address (secondary)

Your state association should have a keyperson network and a legislative chair to help you in identifying your elected representatives and the key issues affecting optometry in your state.

- What is your state law? What are you currently allowed to do? and What would you like to be able to do? What is the legislative process in your state?

Make the effort to meet with your legislators. Go with an experienced member first-watch and listen-see what kind of questions they ask

- “What was the best part of this past session? What has surprised you about this job?”

Get to know your legislator when you don’t need them and they’re not in legislative session. These people live and work in your community. Call them for coffee, lunch, etc. in your district.

Do your homework before meeting your legislator.- What are your common interests-school, children, sports, etc?- Avoid talking politics. Talk about your community, your practice, optometry.

- Avoid talking about scope other than when there is specific legislation.

Invite your legislator to your practice: give them an exam, give them a tour of your office, show them what optometrists do and how you are educated, focus on medical-OCTs, photos, not just optical.

Campaign TimeVolunteer with a candidate you like, and be genuine, as this is your personal investment.

Campaigns cost money and personal hand-delivered checks are especially appreciated.

Get in on the ground level with a candidate, as the relationships built on the campaign trail tend to be some of the strongest in the legislative and political world.

- This can be especially true in races for empty seats or special elections; legislators don’t forget the personal time you put in.

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Identify opportunities that don’t take any money but still hold huge value:- Putting up yard signs, knocking on doors, phone calls, social media/website

contributions, standing at polls on election-day, etc.

Tips During Legislative Session

Be a familiar face at the capital and during legislative events. This will mean taking time away from your practice during weekday work hours on a frequent basis.

Always be sure to properly address your legislator; this is small but important. These elected officials are STATE legislators and NOT FEDERAL:

- Senator, Representative, Delegate, President, Speaker, Chairman/Chairwoman, etc. - Not Congressman

Show up for and be an active participant at your state association’s Legislative Day at your state capitol.

- See your legislature in action and how the process works.- Lunch with legislators, personal meetings in legislator’s office, catch them in the

hallway or outside of committee meetings.

Do not concern yourself with party affiliation. You are an advocate for the profession and not any one political party. Be polite and respectful to all elected officials because this is a long game process. An enemy today could be a friend tomorrow.

Get to know your association’s lobbyists – they can introduce you to legislators, staff and should be experts in the legislative process in your state.

Attend receptions for your legislators in your state capitol or in your hometown community.

When talking about legislation, stick to the key points about the bill, try not to stray from talking points.

- Are you familiar with X bill? Have you taken a position? What is your position?- Personal stories with examples are the best.- It’s OK to not have the answer.- ALWAYS be truthful, credibility is key.

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Tips to Advocate for Legislation

Now that we’ve covered the bases of establishing relationships with legislators, below are a variety of helpful tips to support ongoing advocacy efforts.

We’ve outlined what you should expect as you plan for success prior to the start of the legislation session, how you can activate with energy and finish with decorum and dignity.

Phase One: Plan for Success

Set your timetable and resource accordingly: Remember, politics is a long game. Make sure to plan your resources accordingly based on your timeframe. For example, advocacy and media activities will sometimes require longer-term budgetary support to ensure legislative success. A few tips:

Determine how long it will take to complete the task (e.g., 1 year, 2 years+). Develop a timetable on paper to refer to it regularly and manage progress. Delegate responsibilities to team members and hold them accountable. Make sure you have the financial resources you need.

Prior to the Session: Preparation is key to your success! Use your quiet time before session begins to accomplish the following:

Prepare talking points for your legislators to use during committee testimony and floor debate. Review these with your “Yes” votes to be sure they completely understand and are comfortable speaking to them.

Prepare questions that are difficult for the opposition to answer for your “Yes” votes to ask of them.

Prepare a list of the opponents’ probable arguments and your rebuttal to give to your “Yes” votes.

If the media is involved, select at least two doctors who are/can be media trained and able to respond to media requests.

o Ensure all media requests are referred to the spokespeople you have selected (Advise all doctors of this).

oDo not give any statement to the media yourself.

Utilizing lobbyists: When considering a lobbyist, a good rule of thumb is to hire the ones you don’t want working for the opposition. To protect your interests, here are other guidelines to consider:

Have the lobbyist sign a non-compete clause. Meet with all lobbyists together to go over the bill (They must understand the

bill).

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Ensure they are familiar with each legislator and assign a lobbyist to each legislator based on their relationship.

Take each lobbyist to a doctor of optometry office just as you did with the legislators. (***States with Optometry schools only: Take legislators and lobbyists to visit the school)

Determine lobbyist leader (this should be someone non-threatening).

Familiarize yourself with the Governor’s Veto process: Your efforts only matter if they become law. Do your homework to determine if the governor will veto your bill so you can plan accordingly. Remember:

Too early and you tip your hand. Too late and your hard work is all for naught. Best if a doctor of optometry knows the governor. If not, find and hire a lobbyist

who does.

Phase Two: Activate with Energy!

When the session starts: It’s crucial to have each lobbyist contact their assigned legislator and ask for their vote (this should be reported to the Executive Director.) Other must-have’s include:

Name a lobbyist leader to ride hard and report to the leader (need to get the correct person). The leader needs to be in Capitol as much as possible.

o Legislators and lobbyists need to know who he/she is so their presence is noted.

oHe or she must make sure they all do their job and should report any pertinent information the lobbyists hear to the leader.

If there are special legislative functions such as party functions, fundraisers, etc., be a sponsor and have as many doctors as possible attend.

If there are informal functions such as cookouts, cocktail parties, etc. after the session is over, attend as many as possible or sponsor, if you can.

Negotiations: As the saying goes, if you have the votes, you don’t need to negotiate! If you must negotiate, here are rules to keep in mind:

Don’t give up too much—You don’t need every vote, only a majority. Your negotiators must have authority to make final/binding decisions. If forced to negotiate with the opposition, insist that their negotiations have final

decision authority—or don’t meet. Always have a legislator who is on your side present. NEVER GIVE UP YOUR BOTTOM LINE!

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When the Bill is heard in committee: There is one absolute imperative – you must have every doctor keyperson there looking at his or her legislator. Other important tips:

Never go into committee hearing without knowing the vote. Make sure all your “yes” votes are present and have a two or three vote cushion before hearing your bill.

Have the lobbyist and the doctor keyperson assigned to each one attend. Have two doctors who are good at public speaking, can handle pressure and can

think on their feet, prepared to testify. Greet your legislator at the door as they go into the meeting. Present your case clearly, concisely and in as short a time as possible (the longer

you talk the more problems can arise).o Do not argue and do not bend the truth.o Don’t play the victim—stay on the high road.o Keep in mind-- You are right, the opposition is wrong. The bill has merit!

When the bill is heard on the Floor: It’s crucial every keyperson attend and make sure their legislator(s) know they are attending. Additionally, you should have as many non-keyperson doctors of optometry there as possible—make sure their legislators know they are there, too! Don’t forget:

Have all your lobbyists attend and ensure they contact their assigned legislators about the bill. If possible, have the leader sit where he can communicate with the legislators during the debate.

o Be sure your key legislators know where he is seated. There’s no excuse for doctors not to come to the Capitol as many times as

needed. “Too much time out of the office” won’t fly – lifestyle won’t change and being there may change lifestyle for the better!

After the Vote: It’s important to remember: you are responsible professionals. Win or lose, act with decorum. Notify all doctors ahead of time: when the vote occurs, in committee or on the floor, pass or fail, no outbursts! Legislators will remember it.

After each vote, committee and floor, pass or fail, each doctor should contact his/her legislator to thank them if they voted for the bill.

If the bill fails and the decision is made to go again next year, notify your lobbyists that you want them again as soon as possible, so the opposition can’t get them.

If the bill passes, each member of the team should thank each lobbyist personally.

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Sample Q&A from Legislators

1. The first questions usually revolve around need. -- What is the need for this expansion of scope for optometry? Aren’t patients already getting all the care they need with the current supply of OMDs?

All citizens in (STATE) should have access to affordable, sight saving care. The population is growing and in order to meet the needs of our patients, increasing scope will allow them better access to care.

In other specialties, Medical Doctors delegate tasks and care to other healthcare professionals to meet the growing demand; however, eyecare still lags behind. Our rules for treatment of eye conditions vary from state to state, but the demand for doctors of optometry to perform more advanced care is great and growing.

2. The questions that follow typically revolve around training. -- Are you trained to do this? Do you have enough education and qualifications to perform advanced procedures?

Yes, colleges and schools of optometry teach this level of training. There are competency criteria to be met at the national and state board levels. The state has post-graduate continuing education requirements that address the advances in eyecare.

It’s a known fact medicine as a whole has advanced over the past 50 years. New technology and treatments allow for better outcomes and healthier options. During that time, optometry has also advanced and grown, allowing us to treat and manage very common medical conditions of the eye. We have advanced training in diseases of the eye, pharmacology, and treatment of ocular pathology.

Adequate training and demonstration of competency will be required and regulated by the board of optometry prior to allowing doctors to perform any new procedure.

3. Will advanced procedures be a threat to public safety?

Adequate training and demonstration of competency will be required and regulated by the board of optometry prior to allowing doctors to perform any new procedure. In states with advanced procedures, there has not been an increase in complication rates for these procedures, nor an increase in malpractice rates for the doctors performing them.

4. Will allowing optometry to perform advanced procedures increase health care costs?

No, in fact the cost of health care is less because there is no need for referral, additional testing and evaluations or second opinions. Additionally, the cost to the patient is less since there is no additional travel time and time off from work.

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Optometric Practice Act -- AOA Model Legislation

Note: This is model legislation and should be adapted by a legislative council to conform the proposal with your state law before being introduced to ensure it will be effective in your state.

Definitions(1) Optometry: Practice in which a person employs primary eye care procedures including the

prescription of diagnostic and therapeutic pharmaceutical agents, medical devices and ophthalmic surgery, measures the powers and range of vision of the human eye using subjective and objective means, including the use of lenses and prisms before the eye and auto-refractors and other automated testing devices to determine its accommodative and refractive state and general scope of function; and the adaptation, sale, and dispensing of frames and lenses in all their forms, including plano or zero power contact lenses, to overcome errors of refraction and restore as near as possible normal human vision, or for orthotic, prosthetic, therapeutic, or cosmetic purposes with respect to contact lenses. Optometry also includes the examination, diagnosis, and treatment of abnormal conditions and diseases of the human eye, its adnexa, and visual system, including the use or prescription of vision therapy, ocular exercises, rehabilitation therapy, subnormal vision therapy, ordering of appropriate diagnostic lab or imaging tests, and the dispensing of samples to initiate treatment.

(2) (a) Diagnostic and therapeutic pharmaceutical agent: Any prescription or nonprescription drug delivered by any route of administration, used or prescribed for the diagnosis, treatment, prevention, or mitigation of abnormal conditions and diseases of the human eye and its adnexa, and visual system or those which may be used for such purposes, and approved narcotics when used in the treatment of disorders or diseases of the eye and its adnexa.

(b) Diagnostic and therapeutic pharmaceutical agent: Shall not include any drug or other substance listed in Schedule I of the federal Uniformed Controlled Substances law which shall be prohibited from use by a licensed Doctor of Optometry.

(3) Ophthalmic surgery: A procedure upon the human eye and adnexa in which in vivo tissue is injected, cut, burned, frozen, sutured, vaporized, coagulated, or photodisrupted by the use of surgical instrumentation such as, but not limited to, a scalpel, cryoprobe, laser, electric cautery, or ionizing radiation. Nothing in this chapter shall limit the ability of a Doctor of Optometry to perform ophthalmic surgery procedures other than those listed in Section 5 of this chapter.

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Practice of Optometry(1) Licensed pharmacists of this state shall fill prescriptions for such pharmaceutical agents of

licensed Doctors of Optometry certified by the board (insert appropriate board name) to use such pharmaceutical agents. Licensed Doctors of Optometry certified by the board (insert appropriate board name) may direct or delegate to other healthcare personnel to execute diagnostic and therapeutic orders and administer pharmaceutical agents.

(2) The following ophthalmic surgery procedures are excluded from the practice of optometry, except for the preoperative and postoperative care of these procedures:

(A) The following procedures:(a) Retina laser procedures. (b) Penetrating keratoplasty or corneal transplant.(c) The administration of general anesthesia(d) Surgery done with general anesthesia(e) Laser or non-laser procedure into the vitreous chamber of the eye to treat any

retinal or macular disease.(B) The following non-laser surgical procedures:

(a) Surgery related to removal of the eye from a living human being.(b) Surgery requiring full thickness incision or excision of the cornea or sclera other than

paracentesis in an emergency situation requiring immediate reduction of the pressure inside the eye.

(c) Surgery requiring incision of the iris and ciliary body, including diathermy or cryotherapy

(d) Surgery requiring incision of the vitreous.(e) Surgery requiring incision of the retina.(f) Surgical extraction of the crystalline lens.(g) Surgical intraocular implants.(h) Incisional or excisional surgery of the extraocular muscles.(i) Surgery of the eyelid for suspect malignancies or for incisional cosmetic or

mechanical repair of blepharochalasis, ptosis, and tarsorrhapy.(j) Surgery of the bony orbit, including orbital implants.(k) Incisional or excisional surgery of the lacrimal system other than probing or related

procedures.(l) Surgery requiring full thickness conjunctivoplasty with graft or flap.(m)Pterygium surgery.

(6) In a public health emergency, the state health officer may authorize therapeutically licensed Doctors of Optometry to administer inoculations for systemic health reasons.

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Board Regulation(1) Nothing in this chapter shall be construed as allowing any agency, board, or other entity of

this state other than the (insert appropriate board name) to determine what constitutes the practice of optometry.

(2) The board shall have the sole authority to determine what constitutes the practice of optometry and sole jurisdiction to exercise any other powers and duties under this chapter. The board may issue advisory opinions and declaratory rulings related to this chapter and the administrative regulations promulgated under this chapter.

Credentialing Requirements(1) (Insert appropriate board name) shall establish the credentialing requirements which

shall be fulfilled before a person may be certified to use or prescribe pharmaceutical agents or perform minor surgical and other advanced procedures for the practice of optometry.

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Best Practices for Political Advocacy

POLITICAL AWARENESS ASSESSMENT Maintains Keyperson Network that is updated after each election. Evaluates the quality of keyperson relationships with several keypersons for each legislator. Conducts informal keyperson training sessions at statewide meeting open to any member. Provides an annual event at state Capitol for members to meet and educate legislators about optometry. Members actively meet with legislators at local events and get involved in their races with contributions. Recognizes members for their support to the state PAC at meetings and in

publications or electronic communications. ED has attended SGRC advocacy training sessions and works closely with SGRC and staff.

POLITICAL AWARENESS MONITORING Tracks health legislation looking for opportunities and threats during the legislative session. Identifies legislators who support or oppose scope expansion of other professions. Consistently tracks PAC giving compared with other professions including ophthalmology. Covers both sides of close election races. Tracks level of PAC giving and personal giving to candidates including statewide candidates. Members receive electronic newsletters from their legislators and follow them on social media. Provides optometry only fundraising events for statewide candidates or legislative

leaders. Some events can be co-sponsored with allies like dental association when both states are working on similar bills.

Actively works and educates their lobbying firm about their legislative objectives and the benefits of optometric care. The association does not rely on the lobbying firm alone. The Legislative Committee and board leaders provide oversight and regular communication to membership.

PAC checks are delivered to elected officials and personally delivered by doctors whenever possible. Lobbying firm never delivers contributions. Regularly looks for opportunities to recognize and honor legislative leaders at their

meetings and hosts fundraisers for statewide officers in conjunction with state meetings.

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POLITICAL PREPARATIONS FOR SUCCESS CHECKLIST Educate before they legislate with membership first and then legislators. Legislative

leadership attend SGRC trainings. State leaders take advanced procedures course before selling scope to membership. Have a budget and raise necessary funds for additional lobbying assistance,

educational materials for legislators, media relations firm if needed, etc. State ED and leadership communicates regularly with the SGRC during the

preparation and legislative process for advice and resources. Members have completed initial contacts with key legislators and evaluated their

potential level of support before introducing any bill. They monitor social media and electronic newsletter of legislators to gain political insights and common ground on how to approach them.

Consistently increases and maintains PAC giving during each election cycle. Continuing education courses offered at state meetings provide membership with

background on new technology and advanced procedures. The state association sponsors advanced scope procedures course for their membership.

Legislative updates are a regular part of state meetings and updates.

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ADVOCACY TOOLS & RESOURCES

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Key Messages/Talking Points

Doctors of optometry are a critical key to primary eye health care in the U.S. / STATE. Up to 16 million Americans struggle with undiagnosed of untreated vision impairments.

Combined with the fact that eye diseases, vision loss, and eye disorders create an estimated $139 billion economic burden, the U.S. is facing a significant public health crisis.

Doctors of optometry, the main providers of primary eye care in America, deliver an essential component of patients’ overall primary health. Doctors of optometry provide more than two-thirds of primary eye health care in America and more than 99 percent of the U.S. population lives in counties with a doctor of optometry. In more than 5,800 communities nationwide, doctors of optometry are the only primary eye and vision care providers.

Doctors of optometry are geographically accessible and uniquely available to furnish Americans’ primary eye care services.

And doctors of optometry, also recognized as physicians, deliver care that goes well beyond examining vision acuity to prescribe glasses or contact lenses. An in-person, comprehensive eye exam includes diagnosis and management of eye diseases and treatment of systemic diseases, including diabetes, high blood pressure and even cancer. They prescribe medication to treat eye diseases, treat glaucoma, perform pre- and post-operative evaluations and perform follow-up care.

Doctors of optometry can refer patients to other health care professionals for treatment of advanced eye diseases or general health problems detected during eye examinations.

Comprehensive eye exams are the highest standard of care in clinical vision care. Doctors of optometry are committed to upholding the highest standards of care to

protect patients and their vision health. The eye is one of the most important organs in the human body. Through a

comprehensive eye exam, doctors of optometry can gain insight into a person’s overall health as well as determine eye and vision health.

During a comprehensive eye exam, doctors of optometry not only evaluate vision issues and eye disease, but also can identify early warning signs and manifestations of more than 270 systemic and chronic diseases including diabetes, hypertension and cancer. These diseases may go undetected unless regular visits to the doctor are sustained.

Annual eye exams can positively impact children’s performance at school by addressing vision issues that might limit a child’s early development.

States with expanded optometric scope improve access to critical eye health services and reduce healthcare costs.

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Doctors of optometry should be able to practice to the full extent of their skills and training. The AOA and state affiliates advocate tirelessly to bring state legislation up to date with doctors of optometry’s ability to provide a full range of eye health and vision care to patients.

Optometry is a regulated profession and scope of practice varies between states. Practice rights should not be a political issue that is inconsistent across states but an issue of patient access to quality eye health and vision care.

By allowing all doctors of optometry to practice to the full extent of their training, patients enjoy greater access to the latest procedures and better preventive care as many medical conditions will be caught earlier.

Improved access for patients is a great advantage for senior citizens, as they typically need more frequent exams and diagnostic tests or procedures and many of them find it more difficult to travel longer distances to see a doctor.

Being unable to provide care to their patients with the care they deserve could drive many doctors of optometry to practice in states with greater scope of practice rights.

Understanding the prevalence and cost of eye disorders will help policy makers develop better policies and interventions for preventing and treating vision problems. If appropriate preventive steps are not taken, costs will burgeon as the population ages and life expectancy increases.

Doctors of optometry have extensive education and training to deliver the medically recognized standard of care.

Becoming a licensed doctor of optometry requires an extensive undergraduate and professional medical education. The doctor of optometry program is comprised of additional years of extensive classroom study and clinical training, through intensive, hands-on clinical experience and concentrated disease exposure.

Professional education of doctors of optometry includes general medicine with a concentration on the study of eye health and vision care. The education focuses on diagnosis and treatment of ocular disease conditions, including performing laser procedures and minor surgical procedures of the eyelids and ocular adnexa.

Doctors of optometry are licensed by each state, the District of Columbia and Puerto Rico. While requirements may differ from state to state, optometry school graduates must pass a comprehensive, national examination to prove competence and skill before a license to practice is granted.

Licenses must be renewed annually or biannually. In all states, renewal requires a specified number of hours of continuing education. Throughout their careers, doctors of optometry complete ongoing professional training and education.

Scope of Practice Enactments Timeline22

YEAR Diagnostic Drug Authority

Diagnostic and Prescriptive

Authority at the Same Time

Original Prescriptive Authority to Treat

Disease

Additional Rx or Procedure Authority to Treat Disease

Repeal or Diminishment of

Authority

1971 RI None

1972 None

1973 None

1974 PA None

1975 TN, OR, ME, LA, DE None

1976 CA WV None

1977 WY, NM, MT, KS NC None

1978 KY, WI None

1979 NE, SD, UT, ND, AR, NV, IA

None

1980 GA, AZ None

1981 ID, OK, WA, MO, TX

None

1982 MN, MS, AL, GU None

1983 VA, CO, NY None

1984 OH, SC, MI, VT, IL OK None

1985 NH, HI, MA NM, IA, RI None

1986 DC, CT FL KY, SD, NE, MO None

1987 WY, AR, ID, ND, KS, TN, MT, ME

IA None

1988 AK GA, VA, CO None

1989 MD WA, WI None

1990 None

1991 IN UT, TX, OR IA, SD None

1992 NJ OH, CT, AK None

1993 AZ, MN, SC, LA, NH AR, IA, MT, NE, TN None

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YEAR Diagnostic Drug Authority

Diagnostic and Prescriptive

Authority at the Same Time

Original Prescriptive Authority to Treat

Disease

Additional Rx or Procedure Authority to Treat Disease

Repeal or Diminishment of

Authority

1994 MS, VT, DE, MI GA, OK, SD, WI None

1995 GU, MD, AL, NV, IL, NY GA, ME, MO, NM, WY None

1996 CA, HI, PA CO, CT, KS, KY, ME None

1997 MA AR, HI, ID, MI, NC, ND, RI, UT, WV

None

1998 DC NE, OKi, WV None

1999 PR AZ, KS, MT, NV, TX None

2000 CA, UT None

2001 ND, OR, SC None

2002 CO, HI, IA, MI, NH, PA None

2003 MN, SD, WA None

2004 HI, NJ, OH, OK, VT, VA None

2005 LA, MD, MS, VT None

2006 LA, NH None

2007 AK, AZ, GA, IL, LA, NM, OH None

2008 CA, RI None

2009 ME None

2010 AZ, NH, WV None

2011 AZ, CO, IL, KYi, NH None

2012 USVI IA, KS None

2013 FL, GA, None

2014 LA, AZ, NE, OK, TN, UT, None

2015 IN, NM, None

2016

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2017

TOTALS 45 states, D.C., PR & GU

5 states, USVI 45 states, D.C. & GU 96 states 0

Last Revised July 2018

SUMMARY:

Laws (or rules) establishing or expanding prescriptive or treatment authority for optometrists have been enacted 196 times in the 50 states, the District of Columbia, Guam, Puerto Rico, and the US Virgin Islands.

Laws repealing or diminishing prescriptive or treatment authority for optometrists have never been enacted.

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COMMUNICATIONS TOOLS

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Communications Overview and Recommendations

The Communications Tools included in the following section are intended to support you to prepare, perform and effectively engage with the media and the public around scope of practice.

As we explain below, some of these materials are intended for distribution to the media, while other materials are for wider distribution to the public. Additionally, several materials are for advocates’ internal reference/use only to gain a better understanding of how to engage with media and the public. In all cases, advocates are encouraged to modify the materials as needed, particularly to reflect aspects of the legislation unique to their state.

As you prepare to ramp up communications efforts around scope of practice, it’s important to understand these efforts will meet opposition. As such, you should be prepared to go on the offensive. Before launching communications activities based on the materials in this section, we recommend you:

Update the homepage of your chapter website with core content that supports the value of expanded scope for doctors of optometry (i.e. fact sheets, supportive news articles, etc.).

Be prepared with talking points that expose the mistruths that ophthalmology will begin to spread in response to your efforts.

Identify credible spokespeople and doctors ready to place local and state opinion editorials or letters-to-the-editor.

o As appropriate, conduct media preparation calls with spokespeople. Prepare a social media and general media plan, focused on elevating doctors of

optometry and the care they provide in your state and across the country.

Additionally, a few simple tips to keep in mind when advocating for expanded scope of practice via earned and social media channels, include:

Keep it local: It’s important to address the broader value of expanded scope of practice, but make sure to tailor communications to reflect the data and news relevant to your state. This will increase the likelihood of media coverage and social media dialogue.

Pay attention to the opposition: Keep an eye out for opportunities to draft responsive letters-to-the-editor, opinion editorials or social media posts to counteract arguments from the opposition.

Be supportive: Submit opinion editorials to supportive legislators’ local papers to thank them for their stance. Additionally, you can also thank legislators who introduce bills or support expanded scope on social media, either by posting or “liking” posts that they, or others, have distributed on the topic.

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The communications tools included within this section, which should be personalized based on your location and experiences, are outlined below.

Materials to be modified and shared with lawmakers:o Letter to lawmakers template: Advocates can send messages to their elected

officials that will impact their legislators’ votes. Lawmakers typically use their incoming mail to judge the importance of pending legislation to their constituents.

Materials to be modified and shared with media:o Sample media pitch: E-mail to target reporters to gauge their interest in

covering the issue. Outreach may result in a media interview with a spokesperson who can speak credibly about the benefits of expanded Scope of Practice.

o Opinion editorial (op-ed) template: An op-ed, short for “opposite the editorial,” is a 500-750 word piece expressing an opinion on a current topic and published in a publication by a contributor. The template is an example to be referenced and tailored.

Materials to be modified and distributed externally:o Social media messages: Messages intended for advocates and the public to use

with social media tools, such as Twitter and Facebook. These messages may be used as written or customized to address state-specific issues.

Materials for advocates internal reference/use only:o Media interview tips and techniques: Tips that will strengthen your ability to:

define your position messages; face interviews with confidence and control; assure that your message reaches the audience; and enhance your relationships with media.

o Op-ed how-to-guide: Guidelines and “how-to’s” to help you write, submit/pitch your op-ed, and ensure the op-ed is placed in your preferred media outlet.

o Social media best practices: Tips and techniques to help you communicate effectively on Facebook and Twitter, including the unique qualities of the platforms, best practices and things to consider when posting (e.g., length, hashtags, images, etc.)

Questions should be directed to Daniel Carey, AOA’s Director of State Government Relations, at Dcarey@aoa.org.

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Template Letter to Lawmakers

[Insert Date]

Senator/Representative XXXOffice AddressCity, State, Zip

Dear Senator/Representative XXX,

Healthcare is of crucial concern to most residents in [insert state]. Sadly, many of us are finding it harder to get the care we need. Not only is healthcare becoming more unaffordable, it is also harder to gain access to the healthcare professionals we trust. I’m asking for your support for [bill number, if applicable], legislation that would solve both affordability and access problems.

Up to 16 million Americans struggle with undiagnosed and untreated vision impairments. [insert state-specific data here – e.g. In Pennsylvania alone, the number of residents with impaired vision, including blindness, is expected to double over the next three decades.] Combined with the fact that eye diseases, vision loss, and eye disorders create an estimated $139 billion economic burden, our country is facing a significant public health crisis that must be addressed.

Eighty-five percent of primary eye care is provided by a doctor of optometry. With the aging population, the number of vision related problems are projected to increase by an astounding 65% in the coming years. Legislation allowing doctors of optometry to practice to the full extent of their training would provide patients greater access to the latest procedures and more immediate care since there are more doctors of optometry, particularly in underserved areas.

Yet, the law governing optometric practice has not been updated since [insert year]. Thus, the 99.9% of the population with direct access to optometric vision care is denied access to routine high-quality care in their communities and must incur the added expense of referrals to specialists whose offices are often significant distances away. This results in unnecessary duplication of care and lost time from work.

Doctors of optometry don’t just examine vision acuity. During an in-person, comprehensive eye exam, they can diagnose and manage eye diseases and treat systemic diseases, including diabetes, high blood pressure and even cancer. Doctors of optometry can prescribe medication to treat eye diseases, treat glaucoma, perform pre- and post-operative evaluations, perform follow-up care or refer patients to other health care professionals, if advanced treatment is required.

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It is long past time to allow doctors of optometry to provide the comprehensive eye care they are trained to provide. Doctors of optometry throughout [State] stand ready to support your efforts to ensure residents receive the best vision care. I would be happy to discuss this issue further.

Sincerely,

[Insert Name, address, phone number]

________________________

Making Eye Health A Population Health Imperative: Vision for Tomorrow," sponsors: U.S. Centers for Disease Control and Prevention, National Eye Institute, American Academy of Ophthalmology, American Academy of Optometry, American Optometric Association, Association for Research in Vision and Ophthalmology, National Alliance for Eye and Vision Research, Prevent Blindness and National Center for Children's Vision and Eye Health and Research to Prevent Blindness.2 JAMA Ophthalmology "Public Attitudes about Eye and Vision Health," August 2016. http://archopht.jamanetwork.com/article.aspx?articleid=2540516

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Media Interview Tips and Techniques

IntroductionThe following outlines several interview tips and techniques to help you prepare, perform and effectively engage with the media. These tips will strengthen your ability to:

Clearly define your position messages. Face interviews with confidence and control. Assure that your message gets through to the audience. Enhance your relationships with the media.

Media Interview TipsThe following tips are important to keep in mind when preparing and speaking with reporters.

Prepareo Do your homework. Familiarize yourself with the interviewer and the audience. o Determine the key messages you want to convey and deliver them effectively. o Be sure you have the basic facts and messages at your disposal, on index cards, if

necessary.

Performo Be conversational in tone, you have a great story to tell and appreciate the

opportunity to tell it.o Control the interview. Answer challenging questions briefly and return to your own

agenda. Don’t wait for the interviewer to bring up your topic. It may not happen.

o Support your key messages with colorful anecdotes, examples, and evidence.o To give yourself a moment of reflection without creating an awkward pause, repeat

or rephrase the question before answering. Or, you may use hesitations such as “I’m glad you asked that…,” “Your audience might be interested to know…,”etc.

o Remember nothing is “off the record”, even if you’ve said it and the reporter agrees. Say only what you would want quoted and keep confidential information confidential.

o Immediately correct any inaccurate statements made by the reporter.

Concludeo If you don’t have the answer to a question, offer to follow-up after the interview to

provide additional information and explanation, as necessary.o Encourage the reporter to call you for any clarification or additional information.o Determine when and where the story will appear.

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Interview Control TechniquesThe following techniques help ensure that interviews stay on track and touch on the key talking points.

Bridging: Deal with the question honestly and briefly, then move logically to your message:o “And let me add…”o “In addition…”o “What I can tell you…”o “That reminds me…”o EX: “What I can tell you is that doctors of optometry are able to provide

comprehensive eye exams that can diagnoses eye and vision diseases, as well as detect symptoms of conditions like diabetes and high blood pressure.”

Flagging: Emphasize to the reporter what you want them to highlight — what one piece of information you want them to print or broadcast — by creating a “star” in their notebook.o “The most important point here is…”o “It is critical to understand that…”o “One thing really stands out and that’s…”o “The point is…”o EX: “It’s important to know that doctors of optometry, the main providers of primary

eye care in America, deliver an essential component of patients’ overall primary health care.”

Hooking: You can prompt the next question you want asked by ending your response with a “hook.”o “And that’s just one possibility...” o “We’ve done something no other organization has done.”o EX: “And the great news is that doctors of optometry are geographically accessible

and uniquely available to provide Americans’ primary eye care services.”

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Sample Media Pitch

SUBJ: Doctors of Optometry Can Improve Patient Access to Primary Eye Health Care

Hi [insert reporter name] -

In alarming news, up to 16 million Americans struggle with undiagnosed and untreated vision impairments. [insert state-specific data here – e.g. In Pennsylvania alone, the number of residents with impaired vision, including blindness, is expected to double over the next three decades.] Combined with the fact that eye diseases, vision loss, and eye disorders create an estimated $139 billion economic burden, the U.S. is facing a significant public health crisis.

Unfortunately, those living in underserved or rural areas often face obstacles to accessing eye and vision care. But there’s hope – these problems can be solved by expanding access to affordable, quality eye and vision care delivered by doctors of optometry, who provide more than two-thirds of Americans' primary eye care, often representing the only eye care providers in the most rural parts of the nation.

Legislation allowing doctors of optometry to practice to the full extent of their training would provide patients greater access to the latest procedures and more immediate care since there are more doctors of optometry, particularly in underserved areas. Most importantly, increasing access to doctors of optometry can minimize the devastating impact of vision and eye problems.

Would you be interested in learning more about eye health and how doctors of optometry can improve access to critical eye health services and reduce health care costs in [insert state]? I’m happy to provide additional information and/or coordinate an interview with a spokesperson from XXX.

Thank you for your consideration,

NameOrganizationContact Information____________________________

"Making Eye Health A Population Health Imperative: Vision for Tomorrow," sponsors: U.S. Centers for Disease Control and Prevention, National Eye Institute, American Academy of Ophthalmology, American Academy of Optometry, American Optometric Association, Association for Research in Vision and Ophthalmology, National Alliance for Eye and Vision Research, Prevent Blindness and National Center for Children's Vision and Eye Health and Research to Prevent Blindness.2 JAMA Ophthalmology "Public Attitudes about Eye and Vision Health," August 2016. http://archopht.jamanetwork.com/article.aspx?articleid=2540516

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Opinion Editorial How-to-Guide

Introduction

Thank you for your interest in authoring an op-ed. The following are guidelines and “how-to’s” to help you write, submit/pitch your op-ed, and ensure the op-ed is placed in your preferred media outlet.

An op-ed, short for “opposite the editorial,” is generally a 500-750 word piece expressing an opinion on a current topic and published in a publication by a contributor who is not affiliated with the publication.

Drafting Your Op-Ed

1. Determine your ask/call to action. What key point or message are you trying to share with your audience? This main point should ring clear throughout your op-ed.

2. Put together an outline. This doesn’t have to include complete thoughts or even full paragraphs initially, but it will help to get your ideas and main points down on paper. Most op-eds cannot exceed 500-750 words, so it is important to have a good sense of what you are going to say with the limited amount of words available. Try to limit your op-ed to 2 main points; too many points might dilute your overall message.

a. Sample outline:i. Introductionii. Point #1

iii. Point #2iv. Conclusion

3. Draw from personal experience as much as you can. The more that you can make the op-ed about yourself and why you believe it’s important to position doctors of optometry as the primary eye care providers for Americans, the more your op-ed will resonate with readers. This is your opportunity to share your point of view with readers, and they are willing to hear it!

4. Localize your topic. Can you make the issue relevant to your readers with local data/health statistics to back up your claims? If so, include this information as succinctly as possible.

5. Draw your reader in with a captivating opening. A good way to catch and keep a reader’s attention is to start with an engaging line that draws them in—whether it’s a quick story about your experience as a physician, a patient anecdote or a compelling statement.

6. Use complete sentences. Make sure you are writing in full sentences to illustrate fully your well-thought-out points.

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7. Take a step back. After writing your first draft, step away and take another look with a fresh pair of eyes later. This will help you to catch errors that you might have overlooked before.

8. Proofread! Double check your op-ed for typos and correct formatting - and ensure any hyperlinks work properly.

Pitching Your Op-Ed to The Media

1. Depending on where you live, your local AOA chapter can suggest several target publications where you can consider submitting/pitching your op-ed.

2. Make sure that your op-ed meets the qualifications of the specific publication you’ve selected, such as adhering to each outlet’s specified word maximum.

3. Prepare a short, succinct email to the opinion editor, or appropriate staff member, of your target publication. The note should explain the following: who you are, what your op-ed is about, and why you think the topic is important. Your note should not be more than 3-5 sentences. Include your op-ed in the body of your email below your note as well as an attachment to your email. Not all reporters like attachments, so it is important to include it both ways.

4. If you have not heard from the editor in 2-3 days, follow back up with a phone call or a reminder email. If you still do not hear from the editor, send a final reminder note. If you do not hear a response back in 2 weeks, then you can begin to consider an alternative publication to pitch your op-ed.

5. If the op-ed is accepted and published/posted online, consider sharing it through your personal and professional networks, as appropriate. This could include amplifying the piece on Twitter, Facebook, LinkedIn or via e-newsletter, if appropriate.

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Opinion Editorial Template

Title: Doctors of Optometry Can Improve Access to Primary Eye Health Care – If We’ll Let Them

Up to 16 million Americans struggle with undiagnosed and untreated vision impairments. [insert state-specific data here – e.g. In Pennsylvania alone, the number of residents with impaired vision, including blindness, is expected to double over the next three decades.] Combined with the fact that eye diseases, vision loss, and eye disorders create an estimated $139 billion economic burden, our country is facing a significant public health crisis that must be addressed.

Regrettably, residents of [city] are restricted from getting a full range of optometric care and services even though doctors of optometry have been expertly trained in those very disciplines. As a practicing doctor of optometry in [city] and a member of the [insert name of State Optometric Association], I’m committed to ensuring licensed doctors of optometry are allowed to practice to the full extent of their training. That’s why I’m urging the [state] legislature to [introduce/pass] legislation to increase patient’s access to doctors of optometry.

Unfortunately, those living in underserved or rural areas can often be impacted the most, as they may face more obstacles to accessing eye and vision care than urban residents. They must incur the added expense of referrals to specialists whose offices are often significant distances away. This results in unnecessary duplication of care and lost time from work. Luckily, many of these complications can be solved by expanding access to affordable, quality eye and vision care delivered by doctors of optometry.

Familiar with doctors of optometry? There’s a good chance you received your last comprehensive eye exam from one, since they provide more than two-thirds of Americans' primary eye care. What you may not realize is that doctors of optometry often represent the only eye care providers in the most rural parts of our country. In fact, in more than 5,800 communities nationwide, they are the only primary eye and vision care providers available.

Doctors of optometry don’t just examine vision acuity. During an in-person, comprehensive eye exam, they can diagnose and manage eye diseases and treat systemic diseases, including diabetes, high blood pressure and even cancer. Doctors of optometry can prescribe medication to treat eye diseases, treat glaucoma, perform pre- and post-operative evaluations, perform follow-up care or refer patients to other health care professionals, if advanced treatment is required.

Misinformation on this topic can be rampant, so it’s crucial to understand that becoming a licensed doctor of optometry isn’t easy. It requires extensive undergraduate and graduate medical education and training to deliver the medically recognized standard of care. Overall,

36

the professional education includes general medicine with a concentration on the study of eye health and vision care. Doctors of optometry are trained in the diagnosis and treatment of ocular disease conditions, including performing laser procedures and minor surgical procedures of the eyelids and ocular adnexa. In addition to completing years of extensive classroom study, hands-on clinical experience and concentrated disease exposure, optometry school graduates must pass a comprehensive examination to prove competence and skill before a license to practice is granted.

As such, the public can rest assured that doctors of optometry are highly educated, skilled and licensed professionals who play a critical role in protecting eye and vision health care. The bottom line: with more doctors of optometry geographically accessible, particularly in underserved areas, expanding their scope of practice makes good sense. I urge our elected officials to make the right choice by increasing patients access to doctors of optometry. To learn more about this important issue, and how you can make a difference, please visit [local association website].

________________________

Making Eye Health A Population Health Imperative: Vision for Tomorrow," sponsors: U.S. Centers for Disease Control and Prevention, National Eye Institute, American Academy of Ophthalmology, American Academy of Optometry, American Optometric Association, Association for Research in Vision and Ophthalmology, National Alliance for Eye and Vision Research, Prevent Blindness and National Center for Children's Vision and Eye Health and Research to Prevent Blindness.2 JAMA Ophthalmology "Public Attitudes about Eye and Vision Health," August 2016. http://archopht.jamanetwork.com/article.aspx?articleid=2540516

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Social Media Best Practices

Facebook Best Practices

Facebook is the largest social networking site that makes it easy for brands and consumers to connect and share with family and friends online.

Facebook’s Unique Qualities

• Presents an entirely visual platform• Provides opportunities to:

o Reach hyper-targeted segmentso Activate advocacy baseo Create a two-way dialogueo Share long-form videoso Multi-image posts / unitso Promote Action-oriented activities driving to website, other owned content or

earned coverage

Things to Consider When on Facebook

• Hashtags are not necessary on Facebook• Choose a Facebook post type and paid amplification based on what you’re trying to do,

such as:o Link ad to drive to a websiteo Image or 3-second animation

for awarenesso Sign-up form for lead generationo Carousel to show off different parts

of your brand o Video for deep engagement

Best Practices - Facebook Publishing Principles

CONTENT SHOULD BE DEVELOPED BASED ON NEWSFEED EYEMAPPING

1. Prioritizing the image is most important; it captures users in feed and is where the eye goes first

2. Images should be branded, and critical information should appear on the image itself3. Post copy should be succinct and action-oriented

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4. Logo should remain consistent as profile image to be associated with each post5. Remember, the majority of people will view your content on a mobile device – so we

must take a mobile-first approach.

Best Practices - Facebook Visual Hierarchy

In order of how content is digested:

1. Visual: Instantaneous entry point into content and brings subtext to life2. Branding: Present in every piece of content3. Post Copy: Refers to the visual or adds value but should not be redundant; should be

succinct

Static Imagery Best Practices for Facebook

• Image Size: 1200x900 pxo But can vary depending on usage.o Always check on the FB tool to see if there is too much text on an image.

Twitter: Best Practices

Twitter is the place users go to find out about what’s happening in the world right now – whether it’s music, sports, politics, news, food or everyday moments.

Twitter’s Unique Qualities

• The constant activity and candidness of Twitter allows for brands to quickly and succinctly develop a voice

• Provides opportunities to:o Build relationships and engage with brand advocateso Break news and real-time company or industry updateso Comment on and cover of live eventso Join conversations with other brands, patients or communities

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Things to Consider When on Twitter

• Be ready to engage: on Twitter, 20% of posts should be promotional while 80% should be conversational

• Join in conversations with audiences and engage with other brands in order to build the brand’s identity

• Respond quickly to direct engagement, especially customer service tweets

Twitter Tips

KEEP IT SHORT:

• Focus on one specific message for the most impact

• Longer messages should link to a website or blog

USE BRANDED VISUALS IN YOUR TWEET:

• Add personality by including a branded image, video or GIF

• Twitter users are 3x more likely to engage with tweets that contain videos and photos

INCORPORATE RELEVANT HASHTAGS:

• Hashtags expand your reach and allow you to tap into trending conversations

• Use no more than two hashtags per tweet

• Hashtags should reflect keywords relevant to your business

ASK QUESTIONS & RUN POLLS:

• Questions allow you to engage with your audience and elevate their opinions in the conversation

• Use open-ended questions or polls to survey on specific responses; responses will inform future content

CURATE AND CONNECT WITH RETWEETS AND REPLIES:

• Maintain a robust presence via retweeting and replying to relevant content

• Positive customer feedback, helpful articles, and messages that align with your business’s authentic voice can all be impactful content to retweet

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• When in doubt, remember this rule of thumb: your retweets reflect back on your business and should align with your purpose and values

Static Imagery Best Practices for Twitter

• Image Size: 1024x512 px• Most tweets are seen on mobile devices, so if text is used, ensure it can be read at a

small size

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Sample Social Media Messages

The messages below are intended for advocates and the public to use with social media tools, such as Twitter and Facebook. Each tweet is 280 characters or less, per Twitter requirements. These messages may be used as written or customized to address state-specific issues.

Sample Tweets: #Eye diseases, #vision loss, and eye disorders have $139B estimated economic burden.

Learn how doctors of optometry can help: Insert bitly link to fact sheet/more details

insert bill name will provide greater access to #optometric care for more than [insert state-specific data e.g. 12M Pennsylvanians]. Read more here: insert bitly link to op-ed/website/more details

Who are the main providers of eye care in #state? Doctors of optometry! With extensive education and training, they provide critical primary eye health care. Insert bitly link to fact sheet/more details

Did you know up to 16 million #Americans (or replace with state-specific data) struggle with undiagnosed and untreated #vision impairments? Insert bitly link to fact sheet/more details

Urge your legislators (can tag legislator) to allow doctors of #optometry to practice to the full extent of their training! This will help improve access to critical #eye health services and reduce health care costs: Insert bitly link to fact sheet/more details

Many thanks [tag state representative] for your support of Senate Bill XXX! This legislation will improve [insert state] access to affordable, high-quality #vision care.

In 5,800+ communities nationwide (insert state-specific data, if available), doctors of #optometry are the only primary eye and vision care providers! Allowing them to practice to the full extent of their training is crucial. Insert bitly link to fact sheet/more details

Did you know doctors of #optometry can diagnose and manage eye diseases and treat systemic diseases like #diabetes, high blood pressure and even cancer? It’s true! Learn more: Insert bitly link to fact sheet/more details

Doctors of #optometry are geographically accessible, which is great news for many senior citizens who have difficulty traveling long distances to see a doctor. Insert bitly link to fact sheet/more details

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Why is #optometric scope expansion important? Easy! It will help patients get easier access to critical #eye care. Insert bitly link to fact sheet/more details

Becoming a licensed doctor of #optometry isn’t easy. It requires extensive undergraduate and professional medical education. Learn how doctors of optometry are trained to improve patient health care: Insert bitly link to fact sheet/more details

Comprehensive #eye exams are the highest standard in clinical vision care. Doctors of #optometry can perform these important annual exams. Find yours today: Insert bitly link to fact sheet/more details

Wow! During an annual, comprehensive eye exam, doctors of #optometry can identify early warning signs and manifestations of more than 270 systemic and chronic diseases. Insert bitly link to fact sheet/more details

A doctor of optometry can help detect #diabetes, #hypertension and #cancer symptoms during an annual, comprehensive eye exam. Insert bitly link to fact sheet/more details

Doctors of #optometry do much more than examining vision to prescribe glasses or contact lenses. They can diagnose and manage eye and systemic diseases. Learn more: Insert bitly link to fact sheet/more details

Sample Facebook Posts: Eye diseases, vision loss and eye disorders have an estimated economic burden of $139

billion. Learn how doctors of optometry can help: Insert bitly link to fact sheet/more details

[insert state-specific data] – e.g. In state, the number of residents with impaired vision, including blindness, is expected to double over the next three decades. Fortunately, these issues can be alleviated by expanding access to affordable, quality eye and vision care delivered by doctors of optometry. Insert bitly link to fact sheet/more details

Who are the main providers of eye care in insert state? Doctors of optometry! With extensive education and training, they provide critical primary eye health care. Learn more: Insert bitly link to fact sheet/more details

Urge your legislators (can name state legislator) to allow doctors of optometry to practice to the full extent of their training! This will help improve access to critical eye health services and reduce health care costs: Insert bitly link to fact sheet/more details

Don’t miss our letter-to-the-editor in the insert media outlet about the importance of insert legislation/bill name. This legislation gives us all greater access to optometric care

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by effectively removing barriers for the insert data—e.g. 85 percent of the population that receives its comprehensive vision care from a doctor of optometry. Learn more: insert bitly link

In more than 5,800 communities nationwide (insert state-specific data, if available), doctors of optometry are the only primary eye and vision care providers! Allowing them to practice to the full extent of their training is crucial. Insert bitly link to fact sheet/more details

Doctors of optometry are geographically accessible, which is great news for many senior citizens who have difficulty traveling long distances to see a doctor. Insert bitly link to fact sheet/more details

Becoming a licensed doctor of optometry isn’t easy. It requires extensive undergraduate and professional medical education. Learn how doctors of optometry are trained to improve patient health care: Insert bitly link to fact sheet/more details

Comprehensive eye exams are the highest standard in clinical vision care. Doctors of optometry can perform these important annual exams. Find yours today: Insert bitly link to fact sheet/more details

Wow! During an annual, comprehensive eye exam, doctors of optometry can identify early warning signs and manifestations of more than 270 systemic and chronic diseases. Insert bitly link to fact sheet/more details

A doctor of optometry can help detect diabetes, hypertension and cancer symptoms during an annual, comprehensive eye exam. Insert bitly link to fact sheet/more details

Doctors of optometry do much more than examining vision to prescribe glasses or contact lenses. They can diagnose and manage eye and systemic diseases. Learn more: Insert bitly link to fact sheet/more details

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