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Last Call for 3.20.25 – A prime-time read of what’s going down in Florida

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Last Call – A prime-time read of what’s going down in Florida politics.

First Shot

After a lengthy debate, the House Health & Human Services Committee approved legislation expanding the breadth of procedures and prescriptions administered by optometrists.

Sponsored by Rep. Alex Rizo, HB 449 is this year’s edition of the long-running “Eyeball Wars.” Optometrists have sought authority to provide more advanced care, such as laser surgeries for years. Ophthalmologists firmly oppose any scope of practice expansion.

Both professions require extensive post-baccalaureate education.

Ophthalmologists who attend medical school, receive a medical doctorate, and complete a multi-year residency under the supervision of one or more established ophthalmologists; optometrists hold doctorates in optometry, and while sometimes referred to as “optometric physicians,” they neither attend medical school nor do they complete a residency. 

In practice, optometrists’ primary concern is vision care, such as the provision of corrective lenses. By contrast, ophthalmologists’ focus is eye care, which encompasses the diagnosis and treatment of all maladies involving the eye, impact on vision notwithstanding.

Multiple ophthalmology residents stressed the gravity of that distinction during public testimony. Spencer Barrett, a third-year resident physician at Bascom Palmer Eye Institute in South Florida, emphasized the importance of the highly specialized training he and others in his cohort receive.

“I, as a microsurgeon, would not feel qualified in the slightest to perform brain surgery or vascular surgery or know when to do it any more than I would trust a brain surgeon to operate on the eye because I have not undergone the years of training needed to do so safely,” he told members of the committee.

“Giving optometrists the opportunity to conduct these surgeries and procedures without the training required puts Floridian safety at risk.”

Proponents of HB 449 recognize the distinction between the two professions but say that the current state of eye care access in Florida demands legislative action. 

Rizo bolstered this claim — and even converted an initially reticent committee member from a “nay” to a “yay” — by citing American Medical Association data recommending one ophthalmologist per 4,000 residents in a given region. There are approximately 1,700 ophthalmologists in Florida, which would be adequate for a state of 7 million residents, not Florida’s 23.5 million and growing.

Rizo addressed medical doctors directly in closing: “Everything that you do, every single one of you, every single one of you that is in the medical profession. Thank you. Thank you for what you do.”

He then emphasized that optometrists would only be able to conduct specific, less complex procedures — multiple opponents harped on the vagueness of this section of the bill — and that statistics show the action is warranted.

“The question is not what you look at, but what you see. And I hope that throughout today’s presentation, throughout our conversations, I hope that we can see what we need to do,” Rizo said, quoting Henry David Thoreau.

Committee members voted 13-5 in favor of the bill, which next heads to the House Health & Human Services Committee.

Evening Reads

—“How the Justice Department is remaking itself in Donald Trump’s image” via Jeremy Roebuck, Mark Berman, Perry Stein and Spencer S. Hsu of The Washington Post

—”How the GOP went from championing campus free speech to fighting it” via Jeremy W. Peters of The New York Times

—”The left’s misguided critique of abundance liberalism” via Eric Levitz of Vox

—”Dr. Oz is now the grown-up in the room” via Benjamin Mazer of The Atlantic

—”New College of Florida could take over USF Sarasota-Manatee, Senator says” via Lawrence Mower of New College of Florida

—”Florida’s GOP-led Legislature aims to limit the power of city, county governments” via John Kennedy of USA Today Network-Florida

—”Ron DeSantis wonders why ‘young people’ aren’t doing immigrants’ jobs” via A.G. Gancarski of Florida Politics

—”‘A true champion’: Ben Albritton honored for rural advocacy” via Janelle Irwin Taylor of Florida Politics

—”James Uthmeier wants pay raises, promotions for cops who stop Tesla vandals” via A.G. Gancarski of Florida Politics

—”Every ‘Snow White’ controversy over the film’s tortured production” via Krystie Lee Yandoli of Rolling Stone

Quote of the Day

“Why do we say we need to import foreigners, even import an illegal, when, you know, teenagers used to work at these resorts?”

— Gov. Ron DeSantis, questioning why “young people” aren’t doing immigrants’ jobs.

Put it on the Tab

Look to your left, then look to your right. If you see one of these people at your happy hour haunt, flag down the bartender and put one of these on your tab. Recipes included, just in case the Cocktail Codex fell into the well.

Senate President Ben Albritton gets a Country Life for being recognized as a “true champion” for small-town Florida during Rural Counties Day

Gov. Ron DeSantis may wonder why Florida youth aren’t snapping up jobs once held by immigrants. We presume they aren’t old enough to enjoy a Rise and Grind.

Attorney General James Uthmeier is offering pay raises and promotions to cops who bust Tesla vandals, so why not complete the set with an ice-cold Bounty?

Breakthrough Insights

Tune In

Gators tip off in Big Dane tomorrow

The Gators begin their run in the NCAA basketball tournament tomorrow against Norfolk State (6:50 p.m. ET, TNT).

After winning the SEC tournament, Florida earned the top seed and ended the season with a 30-4 record. This season marks the first time since 2014 that Florida has entered the tournament as a number-one seed. That season, Florida earned a trip to the Final Four.

The Gators’ impressive season included wins over eight teams ranked at the time, including beating Tennessee and Auburn when each program was #1 in the country.

Florida is led by Walter Clayton Jr., who was named this week as a first-team All-American. It is the first time in program history that a Gator has earned first-team All-America honors. Joekim Noah was a second-team All-America selection in 2007. Claton leads Florida in scoring, assists, and field goal percentage. He made 97 three-pointers this season to lead Florida. 

According to ESPN Bet, the Gators are the second favorite to win the national championship. Only Duke, the top overall seed in the tournament, has better odds. The Gators are 28.5-point favorites against Norfolk State.

The Spartans (24-10) won the MEAC tournament to gain the automatic berth into the Big Dance. Norfolk State faced only one ranked team this season, losing to then-top-ranked Tennessee. 

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Last Call is published by Peter Schorsch, assembled and edited by Phil Ammann and Drew Wilson, with contributions from the staff of Florida Politics.


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Ron DeSantis reveals Donald Trump’s role in stopping Bahamian hurricane evacuees from coming to Florida

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Florida’s Governor is speaking out about how President Donald Trump stemmed the tide of Bahamians coming to the state after Hurricane Dorian in 2019.

Speaking at the National Review Institute’sIdea Summit,” Gov. Ron DeSantis described a boat owner who brought people from Freeport to Palm Beach County after the island city got “leveled.”

I’m the Governor of Florida. I can’t have tens of thousands of people deposited in South Florida. It would cost us massive amounts of money. We got a lot of people in Florida with a relationship with the Bahamas,” DeSantis recounted during the talk. “They’ll want to help these people and you can do that, but you do it over there.”

Trump advised DeSantis to contact the Department of Homeland Security. Then one night, the Governor got a call from the President himself.

“We’re scheduled to have a bunch (of evacuees) dumped. I’m in bed. It’s like 12:00. I get a call at 12:30 and he said, ‘Ron, the boat is taken care of.’ Click. And no one ever heard from this boat ever again,” DeSantis said.

The Governor has had interesting takes on Bahamians over the years, including a hypothetical he floated while running for President about people on the island archipelago attacking Florida.

“If people were firing rockets from the Bahamas into, like, Fort Lauderdale, we would never allow that. I mean, we would flatten them. Within like five minutes, we would flatten them,” he said in Eldridge, Iowa, in early December 2023, drawing a parallel to the situation in Israel.

Despite the need for the U.S. Embassy in Nassau to clarify that his comments don’t reflect American foreign policy, the Governor continued to use this metaphor.

But despite using that hypothetical as a crowd-pleaser in Iowa, he never told the apparently real hurricane story until years later.


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Casey DeSantis punts when asked if she’s running for Governor

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The First Couple clearly isn’t ruling out a third term in the Governor’s Mansion, but they aren’t willing to commit to an unprecedented run either.

The looming drama over the Governor’s race is whether First Lady Casey DeSantis runs against Donald Trump-endorsed Byron Donalds in the 2026 Primary.

She sidestepped a direct question at the National Review Institute’sIdea Summit,” extolling her husband as “the GOAT” and offering vague criticisms of other politicians she wouldn’t name as part of a “long-winded answer” that ended with “we’ll see.”

“All that he has done is extremely fragile. You could get somebody in and it could revert back,” she said of Gov. Ron DeSantis.

She also condemned politicians who “think about what’s next on the next political rung in their career.”

“The founders never thought that politics should ever have been a career, right? You were supposed to go up and serve, and you come home and you live under the laws that you pass. But it’s really changed,” said the wife of a man who ran for Senate while in Congress, and then ran for President immediately after being elected Governor a second time.

The Governor said that “leadership is going to continue to matter,” given that forces “in and around Tallahassee” don’t like a lot of what he’s done, and that as a result “the success in Florida is very, very fragile.”

There’s a lot of people that don’t like what we’ve done on the Republican side. And there’s a lot of people that are just kind of waiting like, ‘we just got to get this guy out of here so that we can kind of go back to business.’ There is that sentiment out there,” he said.

“We’ve been the example that a lot of people, conservatives around the country, have pointed to. But I don’t think that this is on autopilot that’s going to continue in this direction.”.

Later in the interview, he promised that Casey, were she Governor, would “be more conservative” than him.


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‘Eyeball wars’ inch closer to optometrists’ side

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An effort years in the making to expand optometrists’ scope of practice is one step closer to becoming reality after the House Health Professions and Programs Subcommittee cleared a measure Thursday. 

The bill (HB 449) received split-party support. Three of the six committee members who voted against the measure were Democrats, and three were Republicans. Meanwhile, two Democrats voted in favor, and 10 Republicans gave the measure a nod. 

The Committee cleared a committee substitute for the bill, which makes some minor modifications to the original measure but maintains the legislation’s general goal.

Opposed by ophthalmologists, it again seeks to allow optometrists to call themselves Doctors of Optometry (O.D.) or “optometric physicians” in advertisements despite significant differences in medical training and education. 

Ophthalmologists complete medical school and a required residency, which typically represents a decade or more of medical training and more than 17,000 hours of patient contact training before such medical doctors are permitted to practice independently. By contrast, optometrists complete a four-year course in optometry, and not all of the programs require a college degree. The training does not include residency or surgical training.

Sponsored by Rep. Alex Rizo, the bill would, among other provisions, allow an optometrist to advertise themselves as an optometrist, licensed optometrist, doctor of optometry, optometric physician, board-certified optometrist, American Board of Optometry certified, Fellow of the American Academy of Optometry, Fellow of the College of Optometrists in Vision Development, residency-trained, or a diplomate of the American Board of Optometry.

It also includes revisions to existing law that would broaden an optometrist’s scope of practice to include additional surgical procedures and prescribing authority.

The committee substitute further redefines “certified optometrist” to include administering and prescribing ocular pharmaceutical agents, medications used to treat or diagnose eye conditions. It also amends educational and certification requirements for administering ocular pharmaceutical agents and authorized ophthalmic surgeries, including the ability to perform laser and non-laser procedures. However, the bill would not allow an optometrist to perform procedures requiring preoperative medications or drugs that alter consciousness, such as general anesthesia. To be certified for authorized procedures under the bill, optometrists must complete a course and pass an examination successfully. 

Ophthalmologists remain opposed, however. Before the committee substitute passage, the Florida Society of Ophthalmology urged lawmakers to vote down the bill, arguing it would endanger patients by allowing less trained optometrists to perform more advanced procedures. 

“Optometrists play an important role in eye health care, providing essential services such as vision testing, prescribing corrective lenses, and detecting certain eye conditions. However, their scope of practice typically does not include surgical procedures involving lasers, scalpels, or injections on or around the eye. These advanced interventions require the specialized medical education, extensive surgical training, and clinical expertise of ophthalmologists,” said Dr. Raquel Goldhardt, the President of FSO.

FSO pointed to research published in the Journal of the American Medical Association on a type of laser surgery to treat glaucoma. It was found that patients who receive treatment from an optometrist are significantly more likely to require additional surgery. FSO further cited incidents of “sight-threatening complications” following optometrist-administered procedures in other states, including Oklahoma, Louisiana, and Kentucky.

Still, those who support the scope of practice expansion argue it increases access to eye care. However, ophthalmologists say most Floridians live within a 30-minute drive to an ophthalmologist, and there is currently no backlog of patients seeking ophthalmologic care in the state.

Rizo has fired back against the critique. 

“What exactly this bill does (is make it so) you don’t have to go to an ophthalmologist, necessarily, if there’s a condition that calls for this particular procedure or pain medication,” he previously told Florida Politics. “No surgery, nothing like that. It’s basically an advanced first-aid procedure to release inter-corneal pressure.”

Rizo carried a similar bill in 2021, but it and its Senate analog died before reaching a floor vote.

The “eyeball wars” date back years, at least to Sen. Don Gaetz’s reign as Senate President, a leadership role he held from 2012 until 2014.

Gaetz coined the term “eyeball wars,” and in 2013, he believed he resolved the turf war between ophthalmologists and optometrists. The two sides settled on a compromise allowing optometrists to prescribe oral medications but not to perform surgery.

But the fight resurfaced a few years later.

bill similar to this year’s effort (SB 1112) died last Session after the House and Senate failed to reconcile. Then-Senate President Kathleen Passidomo, whose father was an ophthalmologist, filed priority legislation that would have blocked the use of the term doctor or physician in certain circumstances, including for optometrists.

The House amended the bill to allow optometrists to use the terms in advertisements. Passidomo successfully ushered the measure through (2023’s SB 230), but Gov. Ron DeSantis vetoed it. Rizo voted that year against efforts to allow optometrists to refer to themselves as doctors of optometry.

This year’s measure has one Committee stop remaining before reaching the House floor, the Health and Human Services Committee. 

A Senate companion has not yet been filed.

If passed and signed by the Governor, the measure would take effect July 1.


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