Performance audit, Arizona Board of Dispensing Opticians

              State of Arizona
Office
of the
Auditor General
PERFORMANCE AUDIT
Report to the Arizona Legislature
By Debra K. Davenport
Auditor General
ARIZONA
BOARD OF
DISPENSING
OPTICIANS
August 2001
Report No. 01-17
The Auditor General is appointed by the Joint Legislative Audit Committee, a bipartisan committee
composed of five senators and five representatives. Her mission is to provide independent and impar-tial
information and specific recommendations to improve the operations of state and local government
entities. To this end, she provides financial audits and accounting services to the state and political
subdivisions and performance audits of state agencies and the programs they administer.
The Joint Legislative Audit Committee
Senator Ken Bennett, Chairman
Representative Roberta L. Voss, Vice-Chairman
Senator Herb Guenther Representative Robert Blendu
Senator Dean Martin Representative Gabrielle Giffords
Senator Peter Rios Representative Barbara Leff
Senator Tom Smith Representative James Sedillo
Senator Randall Gnant (ex-officio) Representative James Weiers (ex-officio)
Audit Staff
Lisa Eddy—Manager
and Contact Person (602) 553-0333
Natalie Coombs—Team Leader
Lois Marks—Team Member
Copies of the Auditor General’s reports are free.
You may request them by contacting us at:
Office of the Auditor General
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Phoenix, AZ 85018
(602) 553-0333
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2910 NORTH 44th STREET • SUITE 410 • PHOENIX, ARIZONA 85018 • (602) 553-0333 • FAX (602) 553-0051
DEBRA K. DAVENPORT, CPA
AUDITOR GENERAL
STATE OF ARIZONA
OFFICE OF THE
AUDITOR GENERAL
WILLIAM THOMSON
DEPUTY AUDITOR GENERAL
August 23, 2001
Members of the Arizona Legislature
The Honorable Jane Dee Hull, Governor
Ms. Careen Heinze, Executive Director
Arizona Board of Dispensing Opticians
Transmitted herewith is a report of the Auditor General, A Performance Audit of the Arizona
Board of Dispensing Opticians. This report is in response to a June 16, 1999, resolution of the
Joint Legislative Audit Committee. The performance audit was conducted as part of the
Sunset review set forth in A.R.S. §41-2951 et seq. I am also transmitting with this report a copy
of the Report Highlights for this audit to provide a quick summary for your convenience.
As outlined in its response, the Arizona Board of Dispensing Opticians plans to implement all
of the recommendations.
My staff and I will be pleased to discuss or clarify items in the report.
This report will be released to the public on August 24, 2001.
Sincerely,
Debbie Davenport
Auditor General
Enclosure
OFFICE OF THE AUDITOR GENERAL
Program Fact Sheet
Arizona Board of Dispensing Opticians
Services: The Arizona Board of Dispensing Opticians is responsible for helping to ensure the
competency of licensed dispensing opticians and for helping to protect the public’s visual
health. To fulfill its responsibilities, the Board performs the following services: 1) conducts
licensing examinations; 2) issues and renews dispensing optician and optical establishment
licenses; 3) ensures licensed opticians comply with continuing education requirements; 4)
investigates and resolves complaints relating to such things as substandard care and failure
to comply with licensing requirements; and 5) provides consumer information to the public.
Revenue: $100,100
(fiscal year 2001)
$0
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
1999 2000 2001
Licenses, fees and permits Other
The Board receives no General Fund
monies. Revenues are primarily derived
from license and examination fees. Ten
percent of Board revenues are remitted to
the State General Fund.
Personnel: One full-time executive di-rector.
The Board consists of seven mem-bers
who serve five-year terms:
¾ Five licensed dispensing opticians
who are in good standing with the
Board; and
¾ Two public members.
Equipment: In addition to standard
office equipment, the Board owns spe-cialty
equipment used in administering
its practical licensing examination, in-cluding:
¾ 5 lensometers ($3,554)
¾ 4 vertometers ($3,780)
¾ 5 dispensing stools ($25)
¾ 3 dispensing tables ($368)
¾ 2 magnifiers ($164)
¾ 2 radiuscopes ($2,852)
¾ 1 pupilometer ($497)
¾ 1 keratometer ($755)
Mission:
“To protect the visual health
of the citizens of Arizona by
regulating and maintaining
standards of practice in the
field of opticianry.”
Radiuscope
Keratometer
Vertometer
OFFICE OF THE AUDITOR GENERAL
Program Goals
(Fiscal Year 2001-2002):
1. To ensure high standards of profes-sional
and ethical conduct in the field of
opticianry through efficient processing
of examination, establishment, and op-tician
license applications and admini-stration
of the State Board of Practical
Examination.
2. To investigate and adjudicate con-sumer-
and Board-initiated complaints
in accordance with statutes and rules in
order to protect the public from incom-petent
services and unprofessional and
unethical conduct.
3. To better protect the public through the
administration of a continuing educa-tion
requirement in order to upgrade
the profession of opticianry in accor-dance
with the Board’s mandate.
Adequacy of Performance Measures:
Although the Board’s three goals appear to
be reasonably aligned with its mission,
auditors identified some problems with the
Board’s performance measures:
¾ The Board lacks some of the perform-ance
measures recommended by the
Governor’s Office of Strategic Planning
and Budgeting, such as the total num-ber
of individuals and establishments
licensed; total number of licenses re-voked
or suspended; percentage of li-censees
with disciplinary actions; and
percentage of applicants or license
holders reporting very good or excel-lent
service.
¾ Some of the Board’s reported informa-tion
appears to be inaccurate or incor-rect
for some reporting years. For ex-ample,
the Board reports that it re-ceived
26 complaints in fiscal year 2000,
but the database indicates that 23 com-plaints
were received. The Board’s per-formance
measures also report 5 disci-plinary
actions taken in fiscal year 1999,
but according to the database, there
were 3.
Facilities: The Board leases office space in
a state-owned building located at 1400 W.
Washington in Phoenix, and its meetings
are held in the same building.
i
OFFICE OF THE AUDITOR GENERAL
SUMMARY
The Office of the Auditor General has conducted a performance
audit and Sunset review of the Arizona Board of Dispensing Op-ticians
pursuant to a June 16, 1999, resolution of the Joint Legisla-tive
Audit Committee. This review is part of the Sunset review
set forth in Arizona Revised Statutes (A.R.S.) §§41-2951 through
41-2957.
Laws 1956, Chapter 32, §1 established the Board to regulate opti-cal
dispensing in Arizona. The Board is responsible for licensing
opticians who dispense eyeglasses, contact lenses, and other op-tical
devices to the public, and who supervise unlicensed practi-tioners.
It also licenses optical establishments that sell prescrip-tion
eyewear to the public to ensure that each is staffed by at least
one licensed dispensing optician. In addition, the Board investi-gates
and adjudicates complaints against its licensees. The Board
consists of seven Governor-appointed members who serve five-year
terms.
The Board is generally functioning well. It typically resolves
complaints and issues licenses in a timely manner. In addition, it
provides consumers with complete information about licensed
opticians’ and optical establisments’ complaint histories.
Because no major operational problems were identified, this re-port’s
discussion is limited to the 12 Factors which, under A.R.S.
§41-2954, the Legislature considers in determining whether to
continue or terminate the Board. This review concludes that, al-though
no significant harm to the public’s health or safety would
likely result if the Board were terminated, the Board does help
protect the public’s welfare through its efforts to resolve com-plaints
and ensure consumers are compensated when appropri-ate.
In addition, by licensing optical establishments, the Board
helps ensure that unlicensed practitioners who work in these set-tings
receive a minimum level of qualified supervision.
Summary
ii
OFFICE OF THE AUDITOR GENERAL
This review recommends that if the Board is continued, it make
some improvements to the administration of its licensing exami-nation
and to its complaint processing. For example, the Board
needs to take steps to ensure that its examination is administered
and scored consistently and appropriately. It also needs to sepa-rate
its complaint investigation and adjudication processes to
better enable it to take disciplinary action when violations occur.
In addition, the review recommends that the Legislature con-sider
revising the Board’s statutes to allow the Board to keep its
examination confidential, eliminate the requirement that con-sumer
complaints be verified, and clarify the statutory licensing
exemption relating to individuals who work under physicians,
optometrists, and licensed dispensing opticians.
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OFFICE OF THE AUDITOR GENERAL
TABLE OF CONTENTS
Page
Introduction and Background..................... 1
Sunset Factors............................................. 7
Agency Response
Table
Table 1 State Board of Dispensing Opticians
Statement of Revenues, Expenditures,
and Changes in Fund Balance
Years Ended June 30, 1999, 2000, and 2001
(Unaudited)............................................... 4
iv
OFFICE OF THE AUDITOR GENERAL
(This Page Intentionally Left Blank)
1
OFFICE OF THE AUDITOR GENERAL
INTRODUCTION AND BACKGROUND
The Office of the Auditor General has conducted a performance
audit and Sunset review of the Arizona State Board of Dispens-ing
Opticians (Board) pursuant to a June 16, 1999, resolution of
the Joint Legislative Audit Committee. This audit was conducted
under the authority vested in the Auditor General by Arizona
Revised Statutes §§41-2591 through 41-2957.
Board Responsibilities
The Arizona State Board of Dispensing Opticians was created in
1956 to regulate opticians and optical establishments that dis-pense
prescription optical devices, such as eyeglasses, contact
lenses, and artificial eyes, to the public. Some of the activities
dispensing opticians perform include working with consumers
to select appropriate eyeglass frames and lens materials; fitting
eyeglass frames to consumers; ensuring proper placement of lens
features, such as bifocal lines; and making eyeglass lenses. Dis-pensing
opticians may also fit consumers with contact lenses.
Although Arizona law also allows unlicensed practitioners to
perform these activities, unlicensed practitioners must be super-vised
by a licensed dispensing optician, physician, or optome-trist.
The Board’s mission is:
“To protect the visual health of the citizens of Arizona by regu-lating
and maintaining standards of practice in the field of opti-cianry.”
The Board accomplishes this purpose by performing a variety of
functions, including enacting rules concerning licensed dispens-ing
opticians and optical establishments; administering a practi-cal
licensing examination; issuing and renewing dispensing opti-cian
and optical establishment licenses; ensuring that licensed
Opticians fit consumers
with contacts and eye-glasses.
Introduction and Background
2
OFFICE OF THE AUDITOR GENERAL
dispensing opticians comply with continuing education re-quirements;
providing information to the public; and investigat-ing
and resolving complaints. The Board receives 18 to 20 con-sumer
complaints each year, which generally relate to unsatisfac-tory
eyeglasses. In addition, the Board initiates 10 to 15 com-plaints
each year, which are typically against establishments that
fail to comply with licensing requirements. Statute requires the
Board to resolve complaints within 150 days, and the Board
meets this timeframe for most complaints. Statute also provides
the Board with a number of disciplinary options, including cen-sure,
probation, restitution, civil penalties, and license suspen-sion
or revocation. The Board resolves many consumer com-plaints
by ensuring that consumers receive refunds for unsatis-factory
eyewear.
Statutory Licensing Requirements
The Board’s statutes and rules contain licensing requirements for
dispensing opticians and establishments. To qualify for a dis-pensing
optician’s license, an optician must:
¾ Complete a three-year apprenticeship or equivalent ap-proved
education and training;
¾ Pass national written contact lens and eyeglass examinations;
and
¾ Pass a Board-administered practical eyeglass and contact lens
examination with a score of 75 percent.
The Board will also extend licensure to opticians who are li-censed
in other states if they have met substantially similar re-quirements.
To maintain licensure, dispensing opticians must
complete 12 hours of continuing education every three years. In
addition, the Board licenses optical establishments that sell eye-wear
directly to the public. Licensed establishments must have at
least one full-time licensed dispensing optician on staff, which
helps ensure unlicensed practitioners receive supervision. The
Board generally issues both initial and renewal licenses in a
Licensed opticians pass
multiple examinations.
Introduction and Background
3
OFFICE OF THE AUDITOR GENERAL
timely manner, and as of January 2001, there were 629 dispens-ing
opticians and 246 optical establishments with active Arizona
licenses.
Organization and Staffing
The Board is comprised of seven Governor-appointed members,
who are each eligible to serve two consecutive five-year terms.
Five of the members must be licensed dispensing opticians who
are in good standing with the Board. The remaining two are
public members.
Currently, the Board is staffed by an executive director who col-lects
application, renewal, and other fees; prepares application
and complaint files for Board review; and provides information
to the public. The Arizona Department of Administration State
Boards’ Office provides office space and administrative assis-tance
to the Board.
Budget
The Legislature appropriates monies to the Board from the
Board of Dispensing Opticians Fund, which contains revenues
derived principally from the collection of license application and
renewal fees. The Board deposits 90 percent of its revenues into
the Board of Dispensing Opticians Fund and the remaining 10
percent into the General Fund. Table 1 (see page 4) illustrates the
Board’s actual and estimated revenues and expenditures for fis-cal
years 1999 through 2001.
Audit Scope and Methodology
Audit work focused on the Board’s performance in accordance
with the 12 Sunset Factors set forth in A.R.S. §41-2954 (see Sunset
Review Factors, pages 7 through 17). The Sunset Factors include
recommendations that relate to the following issues:
¾ The need for the Board to formally approve all license re-newals;
629 opticians and 246
optical establishments are
licensed in Arizona.
Introduction and Background
4
OFFICE OF THE AUDITOR GENERAL
Table 1
State Board of Dispensing Opticians
Statement of Revenues, Expenditures, and Changes in Fund Balance
Years Ended June 30, 1999, 2000, and 2001
(Unaudited)
1999 2000 2001
Revenues:
Licenses, fees, and permits $61,685 $67,180 $ 88,385
Sales and charges for goods and services 1,369 391 2,643
Fines and forfeits 3,335 377 8,816
Other 569 282 230
Total revenues 66,958 68,230 100,074
Expenditures and other uses:
Personal services 37,695 38,897 50,027
Employee-related 6,722 6,633 7,986
Professional and outside services 14,720 21,495 19,235
Travel, in-state 3,520 3,547 3,963
Other operating 5,253 6,882 5,760
Equipment 1,059 1,526
Total expenditures 68,969 78,980 86,971
Remittances to the State General Fund 1 6,691 6,781 10,179
Total expenditures and remittances 75,660 85,761 97,150
Excess of revenues over (under) expenditures and
remittances to the State General Fund (8,702) (17,531) 2,924
Fund balance, beginning of year 54,887 46,185 28,654
Fund balance, end of year $46,185 $28,654 $ 31,578
1 As a 90/10 agency, the Board remits all of its administrative penalties and 10 percent of all other revenues to the
State General Fund.
Source: Auditor General staff analysis of the Arizona Financial Information System Revenues and Expenditures by
Fund, Program, Organization, and Object and Trial Balance by Fund reports for the years ended June 30, 1999
and 2000; and Accounting Event Transaction File for the year ended June 30, 2001.
Introduction and Background
5
OFFICE OF THE AUDITOR GENERAL
¾ The need to improve the usefulness and reliability of the
Board’s practical examination through improvements to ad-ministration
and scoring procedures;
¾ The need for the Board to better separate its complaint inves-tigation
and adjudication procedures to ensure disciplinary
action is taken when appropriate; and
¾ The need for statutory changes relating to complaint-filing
requirements, confidentiality of examination materials and
records, and licensing exemptions for individuals who work
under the supervision of other licensed professionals.
This audit used a variety of methods to evaluate the Board’s per-formance.
To obtain a general understanding of the Board’s op-erations,
auditors interviewed Board members and attended six
of the Board’s monthly meetings conducted between December
2000 and August 2001. Auditors also reviewed statutes and re-lated
information from the 23 states, including Arizona, with
separate dispensing optician boards, and from 12 other states
that regulate opticianry using other methods.
Some additional methods were also used to evaluate specific
Board functions. For example:
¾ To evaluate the Board’s licensure examination, auditors ob-served
the Board’s March 2001 practical examination;
¾ To assess the timeliness of issuing initial licenses, auditors
analyzed a random sample of 10 dispensing optician and 21
optical establishment licenses issued in 2000. Auditors also
assessed the executive director’s procedures for issuing re-newal
licenses;
¾ To determine whether the Board processes complaints in a
timely manner, auditors analyzed a random sample of 26
complaint files received in 1998, 1999, and 2000. Auditors also
reviewed 18 additional files to determine whether the Board
had actually exceeded its statutory 150-day complaint proc-essing
time, and whether there was good cause for doing so;
¾ To determine whether the Board provides consumers with
accurate and complete complaint history and licensing in-
Introduction and Background
6
OFFICE OF THE AUDITOR GENERAL
formation, two auditors posing as members of the public
made calls to the Board requesting information.
This audit was conducted in accordance with government audit-ing
standards.
The Auditor General and staff express appreciation to the Board
of Dispensing Opticians’ members and executive director for
their cooperation and assistance throughout the audit.
7
OFFICE OF THE AUDITOR GENERAL
SUNSET FACTORS
In accordance with A.R.S. §41-2954, the Legislature should con-sider
the following 12 Factors in determining whether the Ari-zona
Board of Dispensing Opticians should be continued or ter-minated.
1. The objective and purpose in establishing the Board.
Laws 1956, Chapter 32, §1 established the Board, which is
responsible for licensing optical establishments and for
helping to ensure the competency of dispensing opticians
who fit and dispense optical devices such as contact
lenses, eyeglasses, and artificial eyes. The Board is also
charged with preventing conduct by dispensing opticians
that may harm the public’s visual health. Under the
Board’s statutes, dispensing opticians are allowed to fill
prescriptions written by physicians and optometrists, and
may also reproduce, or copy, a consumer’s existing pre-scription
eyeglasses. However, they are not allowed to
examine or treat eyes, and cannot prescribe corrective
lenses.
To carry out its responsibilities, the Board is statutorily
authorized to:
¾ Adopt rules specifying dispensing opticians’ lawful
scope of practice and necessary evidence to support a
charge of substandard care by a dispensing optician
or optical establishment;
¾ Determine the eligibility of individual dispensing op-ticians
and optical establishments for licensure; and
¾ Investigate and adjudicate complaints against licensed
dispensing opticians and optical establishments.
Arizona began licensing
opticians in 1956.
Sunset Factors
8
OFFICE OF THE AUDITOR GENERAL
2. The effectiveness with which the Board has met its
objective and purpose and the efficiency with which
it has operated.
The Board’s licensing and complaint processes appear to
be generally efficient and effective; however, some im-provements
are needed to better serve licensees and con-sumers.
¾ Licenses are issued in a timely manner—The
Board appears generally timely in issuing both initial
and renewal licenses for dispensing opticians and op-tical
establishments. Seven of ten applicants sampled
received their licenses in fewer than 75 days. In the
remaining three cases, processing took much longer
because applicants failed the Board’s practical
examination or did not submit required fees.
Auditors also reviewed all 21 of the optical establish-ment
licenses issued in 2000 and determined that the
Board met its required 30-day time frame for issuing
establishment licenses most of the time. However, the
Board did take longer than 30 days to issue licenses to
two establishments, with delays ranging from 5 to 11
days.
Renewal licenses are also processed in a timely man-ner.
However, the Board has not traditionally ap-proved
the issuance of renewal licenses as required by
statute. Instead, the Board’s executive director renews
licenses when completed applications and fees are re-ceived.
In the future, the Board should formally ap-prove
all licenses issued under its name.
Initial and renewal li-censes
are generally is-sued
in a timely manner.
Sunset Factors
9
OFFICE OF THE AUDITOR GENERAL
¾ Licensing examination administration needs im-provement—
Passing the Board’s practical licensing
examination is the final requirement for becoming li-censed.
Applicants who fail the practical examination
are not prohibited from working; however, they must
continue to practice under the supervision of a li-censed
dispensing optician, optometrist, or physician.
Based on auditors’ observations of the March 2001 ex-amination,
several changes are needed to improve its
reliability and usefulness.
  Examination administration—The Board’s ex-amination
consists of five activities, set up as a
“stations.” However, too few station seats were
available to seat all applicants at one time, so
some applicants were asked to wait at the back of
the room until a seat opened up. Applicants then
rotated through the stations as individuals fin-ished
with various activities until all had com-pleted
the examination. This limited proctors’
abilities to ensure that applicants finished at vari-ous
stations within prescribed time limits and did
not return to stations to revise their work.
To improve examination administration, the
Board should only allow as many applicants in the
examination room as can be accommodated by
the various stations at any one time. Time should
be kept for each station, and when the time is up,
the seated applicants should turn in their response
sheets for that station and be removed from the
room. If necessary, a new group could then be
seated.
  Examination scoring—The Board’s examination
scoring is inconsistent and potentially inaccurate.
Scoring criteria, or tolerances, are printed on each
test so that applicants are made aware of how
precise their answers must be to obtain credit.
However, some of the printed tolerances were
found to be inaccurate or inconsistent. For exam-ple,
the examination listed two acceptable toler-
Better controls are needed
when the examination is
administered.
Grading criteria is un-clear.
Sunset Factors
10
OFFICE OF THE AUDITOR GENERAL
ances for measuring the diameter of a contact
lens. The Board indicates it is currently reviewing
and revising its examination. As part of that re-view,
it should update the examination scoring
criteria and ensure that it matches industry stan-dards.
In addition, the Board’s scoring procedures are
prone to error. Currently, the Board’s professional
members participate in grading examinations but
each member does not apply scoring criteria con-sistently
to ensure accurate examination results.
Of 24 examinations, Board members agreed with
the initial examination grade in only 7 instances.
In the remaining 17 cases, grades were changed
one or more times. In one of the more extreme
cases:
To minimize error, the Board should train two
members or outside individuals to grade examina-tions,
provide the graders with clearly articulated
scoring criteria, and establish a procedure for veri-fying
the accuracy of the grades issued.
Finally, the Board does not remove applicants’
names from examination answer sheets prior to
grading the examination. Because this could lead
An examination was originally scored at 79.5 per-cent,
which was above the required passing score of
75 percent. However, when other Board members
verified the score, the grade was changed to 77 per-cent,
and then again to 73.5 percent, which was de-termined
to be the final grade. The applicant was
informed of the failing grade and requested that the
Board rescore the examination. However, when the
Board rescored the examination, it determined that
the correct grade was actually 69.5 percent.
Example 1
Examination grading is
inconsistent.
Sunset Factors
11
OFFICE OF THE AUDITOR GENERAL
to bias, the Board needs to establish a procedure
for removing all identifying information before
examinations are submitted to graders.
  Examination usefulness—Currently, the Board
informs applicants whether they passed or failed
the examination, but does not provide additional
detail unless specifically requested to do so. Be-cause
many of these applicants are currently dis-pensing
eyewear to the public, the Board should
provide information to failing applicants about
which skills need improvement.
¾ Complaint handling is generally timely, but some
process improvements are needed—The Board
processes most complaints within its required 150-day
statutory time frame; however, it needs to ensure that
it adequately separates its investigation and adjudica-tion
functions.
  Timeliness—The Board’s complaint process is
generally timely, with complaints being resolved
within 113 days, on average.1 A few complaints,
however, do take longer to resolve than the 150-
day statutory time frame. Of the 75 complaints re-ceived
between 1998 and 2000, 7 took longer than
150 days to resolve. Resolution times for these
complaints ranged from 154 days to 330 days,
with the extended processing time attributable to
such things as attorney requests for postpone-ments
and more complex investigations.
  Investigation and adjudication—The Board
should adequately separate its investigation and
adjudication processes. Board members typically
investigate complaints. However, in a few in-stances,
investigating Board members have also
become involved in attempting to informally set-tle
complaints. For example:
1 Based on an analysis of a random sample of 26 complaints filed in 1998,
1999, and 2000.
Failing applicants need to
know which skills need
improvement.
On average, complaints
are resolved within 113
days.
Sunset Factors
12
OFFICE OF THE AUDITOR GENERAL
This type of informal mediation can impact the
Board’s ability to act. For example, in the above
case, if the Board member had not already worked
out an agreement with the parties, the Board
would still have likely ordered the licensee to pay
restitution to the consumer. However, this would
have been a formal Board disciplinary action that
would have become part of the licensee’s public
record that is available to all consumers. This for-mal
disciplinary record could also be considered
when future complaints against this licensee are
resolved.
3. The extent to which the Board has operated within
the public interest.
The Board has generally operated in the public’s interest.
For example, through its licensing process, the Board en-sures
that licensed opticians who dispense eyewear and
who supervise nonlicensed individuals have obtained a
minimum level of training and have been examined to
help ensure competency. In addition, the Board’s com-plaint
resolution process is timely and focused on resolv-ing
consumer concerns. The Board also provides con-sumers
with information about licensees, including com-
A Board member investigated two complaints alleging
that an establishment dispensed unsatisfactory eye-glasses.
The investigating Board member found that the
eyeglasses had been made incorrectly and noted potential
rule violations. However, rather than presenting these
findings to the Board and allowing it to act, the investigat-ing
Board member presented the findings to the optical
establishment and recommended that a refund be issued.
The establishment did issue a refund, and based on this,
the investigating Board member recommended that the
Board dismiss the complaints. The Board dismissed the
complaint since the two parties had been satisfied.
Example 2
The Board should act
when violations occur.
Complaint resolutions are
consumer-focused.
Sunset Factors
13
OFFICE OF THE AUDITOR GENERAL
plaint histories and any required remediation actions,
such as refunding monies to consumers.
4. The extent to which rules adopted by the Board are
consistent with the legislative mandate.
According to the Governor’s Regulatory Review Council
(GRRC), the Board has promulgated most of the rules re-quired
of it. The Board has been provided with the full
text of GRRC’s recommendations, which outline rules
needed for such things as license reinstatements; fees
charged for late renewals, name changes, and duplicate
licenses; and disciplinary actions. The Board will begin its
five-year rules review this coming fall and should con-sider
GRRC’s analysis as it develops any additional rules.
5. The extent to which the Board has encouraged input
from the public before adopting its rules, and the e x-tent
to which it has informed the public as to its a c-tions
and their expected impact on the public.
The Board indicates that it has sought public input when
promulgating its rules. In addition, the Board makes an
effort to keep the public informed of its other activities by
posting public notices and agendas 24 hours in advance,
and by keeping appropriate meeting minutes. Further,
the Board sends periodic newsletters to licensees that in-clude
information about the Board’s meeting schedule.
Finally, the Board supplies information about its meet-ings
to the Arizona Association of Dispensing Opticians
for publication.
6. The extent to which the Board has been able to in-vestigate
and resolve complaints that are within its
jurisdiction.
The Board has sufficient statutory authority and discipli-nary
options to investigate and adjudicate the few com-plaints
it receives each year, and its investigation and ad-judication
processes are timely.
Sunset Factors
14
OFFICE OF THE AUDITOR GENERAL
7. The extent to which the attorney general or any other
applicable agency of state government has the au-thority
to prosecute actions under the enabling
legislation.
Pursuant to A.R.S §41-192, the attorney general has the
authority to prosecute actions and represent the Board in
civil actions. The Board currently has a number of disci-plinary
actions that it may take against licensees who vio-late
the Board’s statutes or rules. It can also seek court in-junctions
against a person who violates the Board’s stat-utes
or rules, and may impose a civil penalty of up to
$1,000 against unlicensed optical dispensers and estab-lishments.
These civil remedies are in addition to criminal
prosecution allowed under A.R.S. §§32-1696 and 32-1697,
which establish that violations of the Board’s statutes, in-cluding
unlicensed practice, are misdemeanor offenses.
Further, A.R.S. §32-1698 provides for city and county
prosecutors to pursue cases involving unlicensed activity;
however, the Board indicates that prosecutors’ offices of-ten
view misdemeanor cases as a low priority and mem-bers
are unaware of any criminal prosecution resulting
from unlicensed activity.
8. The extent to which the Board has addressed defi-ciencies
in its enabling statutes which prevent it from
fulfilling its statutory mandate.
In 2000, the Board received statutory authority to impose
civil penalties of up to $1,000 against unlicensed indi-viduals
and establishments that violate the Board’s stat-utes.
The change allows the Board to take action in cases
involving unlicensed practice rather than relying solely
on county and city prosecutors’ offices to pursue criminal
charges.
Sunset Factors
15
OFFICE OF THE AUDITOR GENERAL
9. The extent to which changes are necessary in the
laws of the Board to adequately comply with the fac-tors
listed in the Sunset review statute.
The Legislature should consider modifying the following
statutes to better enable the Board to fulfill its responsi-bilities:
¾ A.R.S. §32-1691.01(B) should be modified to no longer
require that complaints be verified. To comply with
the current law, the Board requires complaints to be
notarized, which can be an added barrier for consum-ers.
¾ A.R.S. §32-1682(D) should be modified to allow the
Board to keep its examination confidential. Currently,
the Board lacks any provision for maintaining the
confidentiality of examination materials, including
answer keys and completed applicant examinations.
¾ A.R.S. §32-1691(2) should be clarified to specify that
only unlicensed individuals working under the super-vision
of a physician, optometrist, or licensed dispens-ing
optician are exempt from meeting licensure re-quirements
and standards (unlicensed added). The
Board’s assistant attorney general representative has
advised the Board that this statute, as currently writ-ten,
prevents the Board from taking action against any
individual, licensed or unlicensed, who works under
the supervision of another licensed professional.
10. The extent to which the termination of the Board
would significantly harm the public health, safety, or
welfare.
Although terminating the Board would not significantly
harm the public’s health or safety, the Board does play a
role in helping the public to resolve consumer complaints.
The Board currently licenses approximately 629 dispens-ing
opticians and approximately 246 optical establish-ments.
In addition, there are numerous other unlicensed
individuals involved in dispensing eyewear who work
The Board helps to resolve
consumer complaints.
Sunset Factors
16
OFFICE OF THE AUDITOR GENERAL
under physicians, optometrists, and licensed dispensing
opticians. Despite the large number of practitioners and
establishments involved, few complaints are filed. Audi-tors
reviewed the 39 consumer complaints filed between
1999 and 2000 and did not identify any instances result-ing
in significant harm to consumer health or safety.
However, the public’s welfare can be at risk if consumers
are unable to obtain refunds or replacements for unsatis-factory
eyewear, which may cost anywhere from $30 to
$450 based on the cases reviewed. The Board provides
consumers with another avenue for resolving these types
of complaints, and the Board’s efforts often result in com-pensation
for complainants.
11. The extent to which the level of regulation exercised
by the Board is appropriate and whether less or more
stringent levels of regulation would be appropriate.
The level of regulation exercised by the Board appears to
be generally appropriate. Currently, unlicensed individu-als
are allowed to dispense optical devices as long as they
work under a physician, optometrist, or licensed dispens-ing
optician. This level of regulation allows for increased
access to the profession while, at the same time, helping
to ensure a minimum level of supervision by qualified
practitioners.
12. The extent to which the Board has used private con-tractors
in the performance of its duties and how e f-fective
use of private contractors could be accom-plished.
According to the Board, it has historically used private
contractors for such things as court reporting and com-puter
programming. In addition, the Board currently has
intergovernmental agreements with the Arizona De-partment
of Administration for office space and adminis-trative
support and for equipment maintenance and re-pair.
OFFICE OF THE AUDITOR GENERAL
Agency Response
OFFICE OF THE AUDITOR GENERAL
(This Page Intentionally Left Blank)
August 2, 2001
Debra K. Davenport, CPA
Auditor General
State of Arizona
2910 N. 44th Street, Suite 401
Phoenix, Arizona 85018
Re: Performance Audit and Sunset Review
Dear Ms. Davenport:
Enclosed is the Arizona State Board of Dispensing Opticians' response to the
performance audit conducted by your office, pursuant to a June 16, 1999, resolution of
the Joint Legislative Audit Committee.
The Board appreciates the time and effort expended by your office on the production of
this report. The report is viewed as a valuable tool to direct the improvement of board
operations.
The Board will be assessing its procedures and implementing most recommendations
contained in the audit report.
Sincerely,
Careen J. Heinze
Executive Director
AUDIT RESPONSE
Performed in response to a June 16, 1999, resolution of the Joint Legislative Audit
Committee
The Board generally agrees with most of the recommendations set forth in the
Audit Report and will work to improve performance by implementing the
recommendations in areas of concern.
In response to the statement "This review concludes that, although no significant
harm to the public's health or safety would likely result if the Board were terminated . . ."
the Arizona State Board of Dispensing Opticians maintains that there is a strong
potential for significant harm to the public's visual health without a licensing agency to
evaluate and regulate opticians and optical establishments charged with the duty of
providing eyecare to the public. The very fact that there have been no documented
instances of significant harm to the public's visual health clearly affirms that the Board is
providing a valuable service to the citizens of Arizona. It is testimony to the Board that
there has been no recorded loss of vision caused by an optician in Arizona. However,
this record is being challenged with the ever-increasing casual use of corneal contact
lenses. In many cases, these contacts are being sold by unregulated sources and there
is a distinct failure to educate the contact lens user as to the hazards of improper fit and
care of contact lenses. Mal-fitting contact lenses could result in corneal ulcers that can
cause serious damage to the eye. Corneal contacts are being viewed by consumers as
"cosmetic appliances" when they are, in fact, medical devices as defined and controlled
by the Food and Drug Administration. The sale of these medical devices by unlicensed
individuals to consumers who are uneducated in the use of contact lenses greatly
increases the potential for eye damage.
PRACTICAL EXAMINATION
The Board agrees with the finding of the Auditor General that the administration
of the Practical Examination needs improvement and an Examination Review Committee
consisting of three Board members will be reviewing procedures and implementing
improved procedures that will conform, in part, to audit recommendations.
Audit Response
August 2, 2001
Page Two
The following is a means to explain the current practical examination procedures:
The audit report states that there are too few "stations" for applicants. A "station"
consists of a calibrated ophthalmic instrument and the materials to be
measured/evaluated. Due to budget limitations the Board is unable to provide "stations"
for all applicants sitting for the Practical Examination as the opthalmic instruments
involved are costly.
The entire Board is present and participating at every examination. Members act
as proctors assigned to different stations. These proctors time the applicants at each
station and assist in the movement of applicants between stations.
Interrupting the continuity of the examination by having applicants moving in and
out of the examination site could compromise the integrity of the examination. The
committee will consider setting the practical examination dates on days other than
meeting days and having two separate groups sit for the examination: one in the a.m.
and one in the p.m. This would eliminate the "congestion" with so many people
functioning in one conference room.
The scoring of the practical examination will be assigned by the Chairman to two
of the Board members who have been trained in scoring the practical examination. One
member will score the examination, using clearly defined scoring criteria and a second
member will verify the accuracy of the grade issued by the first member. These Board
members will remove themselves from the presence of the remaining Board members.
The Board agrees that the applicants' names should not appear on the
examination answer sheets and will implement a new procedure in that regard at its
September practical examination.
The Board, upon written request by the applicant, will provide detailed
information as to which areas need improvement in order to perform the duties of an
optician effectively.
Audit Response
August 2, 2001
Page Three
INVESTIGATION AND ADJUDICATION
Because of the specialized, technical nature of complaints concerning the
manufacture of contact lenses and eyeglasses, it is imperative that trained opticians
investigate the possibility of improperly manufactured eyewear. The Board has
performed its own investigations from the date of the Board's inception. Due to budget
limitations, it is not economically feasible to consider hiring an outside investigator.
There are some well-qualified, retired, licensed opticians in Arizona who have indicated
a willingness to investigate complaints for the mandated daily reimbursement of the
Board members. This could be an avenue the Board will pursue in future investigations.
In an effort to resolve complaints and satisfy the consumer, in some cases, the
investigating Board member has attempted to effect a resolution. This practice will be
discontinued and investigative reports will contain only facts and findings, with a
suggested recommendation for Board action.
STATUTORY REVISIONS
The Board agrees with all recommended revisions to its statutes.
Other Performance Audit Reports Issued Within
the Last 12 Months
01-10
Future Performance Audit Reports
Arizona Department of Corrections—Administrative Services and
Information Technology
Arizona Department of Corrections—Arizona Correctional Industries
00-18 Arizona State Boxing Commission
00-19 Department of Economic Security—
Division of Developmental
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00-20 Arizona Department of
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00-21 Universities—Funding Study
00-22 Annual Evaluation—Arizona’s
Family Literacy Program
01-1 Department of Economic Security—
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01-2 Department of Economic Security—
Healthy Families Program
01-3 Arizona Department of Public
Safety—Drug Abuse Resistance
Education (D.A.R.E.) Program
01-4 Arizona Department of
Corrections—Human Resources
Management
01-5 Arizona Department of Public
Safety—Telecommunications
Bureau
01-6 Board of Osteopathic Examiners in
Medicine and Surgery
01-7 Arizona Department
of Corrections—Support Services
01-8 Arizona Game and Fish Commission
and Department—Wildlife
Management Program
01-9 Arizona Game and Fish
Commission—Heritage Fund
01-10 Department of Public Safety—
Licensing Bureau
01-11 Arizona Commission on the Arts
01-12 Board of Chiropractic Examiners
01-13 Arizona Department of
Corrections—Private Prisons
01-14 Arizona Automobile Theft
Authority
01-15 Department of Real Estate
01-16 Department of Veterans’ Services
Arizona State Veteran Home,
Veterans’ Conservatorship/
Guardianship Program, and
Veterans’ Services Program