Advancing the Scope of Practice for Pennsylvania Optometry

As optometrists, we have the privilege of being the first line of defense in protecting our patients' vision and eye health. However, as the demands of healthcare evolve, so too must our ability to provide comprehensive care. The need to advance the scope of practice for optometry in Pennsylvania has never been more critical. It’s not just about enhancing what we can do—it's about ensuring that our patients receive the best possible care and that our profession continues to thrive in the future.

Across the country, we’ve seen significant strides in scope expansion. States like Kentucky, Louisiana, and Oklahoma have successfully advanced their scope of practice, allowing optometrists to perform procedures such as laser surgeries, administer injections, and manage a broader range of ocular conditions. These advancements didn't happen overnight—they were the result of persistent advocacy, rigorous training, and a commitment to patient safety.

One of the most compelling arguments in favor of scope expansion comes from a study that evaluated the safety and effectiveness of advanced optometric procedures. This study found that doctors of optometry perform these procedures with a high degree of safety, comparable to other healthcare providers. The findings underscore what we have known all along: that with the right training and education, optometrists are more than capable of delivering advanced care safely and effectively.

So, why should Pennsylvania optometrists advocate for scope expansion? Here are the top five reasons:

1. Improved Access to Care: Expanding our scope allows patients to receive comprehensive care more quickly, without unnecessary referrals or delays.
2. Enhanced Patient Outcomes: With the ability to manage more complex cases, optometrists can provide more timely interventions, leading to better outcomes for our patients. 
3. Cost-Effective Care: By enabling optometrists to perform advanced procedures, we can reduce the overall cost of eye care by minimizing the need for multiple specialists.
4. Reduction in Healthcare Burden: As primary eye care providers, expanding our scope allows us to alleviate the burden on other healthcare providers, particularly in underserved areas.
5. Professional Growth and Satisfaction: Scope expansion opens new avenues for professional development, allowing us to grow and excel in our careers while meeting the evolving needs of our patients.

While many optometrists in Pennsylvania are content with their current practice, it is essential to recognize that scope expansion is not just about today—it’s about our future. It's about ensuring that the next generation of optometrists has the tools and authority to meet the challenges of tomorrow's healthcare landscape. 

If we are not advancing, we are moving backward, not just simply standing still. By resisting change, we risk being left behind, not only as a profession but in our ability to provide the highest standard of care to our patients. As we look to the future, let’s remember that the fight for scope expansion is not just for us—it’s for every optometrist who will follow in our footsteps, and for every patient whose vision and quality of life depend on our care.

Let’s work together to ensure that Pennsylvania remains at the forefront of optometric care, providing our patients with the best that our profession has to offer.

In Service and Progress,  

James Deom, O.D., M.P.H., F.A.A.O., F.S.L.S. 

President, Pennsylvania Optometric Association

Looking back...and ahead

The first quarter is now in the rearview mirror and we are well into spring. Let's take a few moments to look back at what we have accomplished over the last couple of months at the POA and what we have set our sights on for this coming summer and fall. 

In late March, there was a substantial showing of POA optometrists at Senator Chris Gebhard’s fundraiser. The Senator, currently sponsoring the children’s vision bill, and his staff were impressed by the number of ODs present at the event and appreciative of the tremendous support shown. Leading into April, our annual Spring Congress in Gettysburg was a massive success! There was an array of quality continuing education with high attendance, robust engagement between industry supporters and doctors in the exhibit hall, roaming Welcoming Ambassadors, the second POA Board meeting of 2023, our House of Delegates, the annual POA Awards Ceremony, and plenty of social events for friends and families to mingle and have some fun. It was a memorable weekend for sure!

In March and April, the POA and the Pennsylvania Academy of Ophthalmology (PAO) continued a dialogue on several different initiatives where Optometry and Ophthalmology are confident we can work together. Some of these efforts will include low vision, scleral and medically necessary contact lenses, third party center mutual challenges, and medicaid.

From June 21 to 24, Optometry’s Meeting and AOA on Capitol Hill will be held  in Washington, D.C. Please contact me, or the POA office, if you would like to act as a Pennsylvania delegate at the AOA House of Delegates. Please also consider advocating with us for our patients and our profession on the Hill in Washington that same weekend. 

Keep alert for more details on another course on Ophthalmic Laser Procedures for the Anterior Segment presented by Salus University and supported by the POA. It will be on the road in Western Pennsylvania sometime this fall. 

Additionally, you should save the dates of September 29 and 30 to volunteer in Harrisburg by performing eye exams in an underserved area. 

And lastly, please join us November 1 to 3 for our final 2023 POA Board of Directors meeting and Fall Educational Conference with an exhibit hall in luxurious Bedford Springs!

I am immensely proud of what our POA Board, committees, and staff have accomplished so far this year. Let the hard work and collaboration continue! I look forward to seeing you again soon and, of course, meeting new people too.

Appreciatively,

Jesse

POA's upcoming events

Winter is flying by and spring is almost here! So far, 2023 has been very productive for the POA. The course presented by Salus University in partnership with the POA, Ophthalmic Laser Procedures for the Anterior Segment, was a huge success. Dozens of optometrists successfully completed this high-quality training. If you missed it, don’t worry, the opportunity for this instruction will be provided again soon. 

Since the first Board of Directors meeting in January, the POA’s volunteer committees and Board have been active. The Legislative Affairs Committee reported in early January that Senator Chris Gebhard released a co-sponsorship memoranda increasing the effectiveness of eye health examinations for our children in Pennsylvania, which the POA fully supports. Please contact the POA office if you need talking points to help communicate the importance of this bill to your legislators. 

Additionally, the new Diversity, Equity, and Inclusion Committee participated in a workshop entitled “Moving Toward Inclusion and Belonging”. The POA will continue pursuing these important efforts as it continues to grow its membership. Please check out the updates from other POA committees in this edition of the Keystoner as well. 

The POA’s annual Spring Congress is right around the corner, on March 30th to April 2nd, at the Wyndham Gettysburg Hotel. Aside from the Board of Directors meeting, continuing education, and House of Delegates, it will be your chance to take in all that historic Gettysburg has to offer. As an alumnus of Gettysburg College, I know you’ll love your experience there. In addition to the many tours and museums, you won’t want to miss some of our special events. There will be the 2023 Gettysburg Historic Road Rally, our annual awards ceremony, a Saturday night ghost gathering, the exhibit hall with tons of eager and knowledgable company representatives, and the State of the Association Lunch. On Friday, you’re invited to my “Represent your Alma Mater” night at the Battlefield Brew Works featuring, none other than, The Mark Margolies Band live onstage! Every attendee will get a free CD. Be sure to wear your school gear and bring any paraphernalia from your institution. What a fun, action packed weekend it will be. 

After the Spring Congress, the POA will continue its work on your behalf. Please take a moment to look at the POA committee structure and see if you find an area of interest that you would like to participate in. If so, inform me or Ilene Sauertieg of the POA staff at Ilene@poaeyes.org. 

Keep an eye out for news of the next POA lobbying day in Harrisburg, due to be held in the late spring to early summer. Also, mark your calendar for an event in Harrisburg where POA volunteers and paraoptometrics will be providing eye exams in an underserved area on September 29th and 30th. 

I am incredibly excited to be with old friends and see new faces in Gettysburg. See you soon!

Jesse Jones, O.D.

POA President

Your POA to do list

Happy New Year, everyone! I am honored, excited, and motivated to lead the POA for 2023. I’m looking forward to working with those I know well and getting to know new people, too. The POA Board of Directors is enthusiastic to meet those interested in contributing their skills in advocating for optometry. I hope everyone is refreshed and ready for an effective and efficient year. 

As we review our to do lists for this upcoming year, the following are some items you might add to yours:

First, open the POA Table of Organization. Examine the intricate structure of our organization and how it works for you, your colleagues, and, ultimately, your patients. It's impressive, isn’t it? 

Then, you can get more acquainted with the specific goals and action plans to be carried out within each committee. Consider if any of the committees are of particular interest to you and contact me, the POA office, or a POA Board member if you would like to serve. 

Next, check out the POA keyperson program. You can look up your current senators and representatives, and educate yourself with valuable keyperson training programs and materials. When contacting your legislators, inform them of your availability to discuss anything relating to eye care and our legislative efforts including our children’s vision initiative and scope modernization. 

Check out our Pennsylvania Diabetic Eye Health Alliance and Children’s Vision Care Alliance. When reviewing these important programs, assess if you are maximizing what these programs have to offer to you and your patients. Don’t forget to request the new near point card for school nurses in your area! Also, get two hours of TPA CE toward your license by registering for the “Innovations in Pharmaceuticals and Their Clinical Applications” webinar by Dr. Paul Karpecki on January 23. 

Additionally, get reacquainted with POPAC and consider committing to a monthly donation if you haven’t already. Learn how our organized political action has expanded to incorporate grassroots efforts lined out in the Proactive Optometry Initiative.

Finally, please mark your calendars for the POA Spring Congress in Gettysburg from March 30th to April 2nd along with our Fall Education Conference in Bedford Springs November 1st through 3rd. I am eager to see as many members as possible in person this year. We are developing creative new ways to expand and improve our efforts in welcoming and including all optometrists in Pennsylvania. The POA will also be enhancing communication in all aspects within the POA Board, POA staff, POA committee structure, general membership, and to non-members and the public. 

I anticipate a successful year, building on the hard work of the POA’s previous leadership and doing my best to direct and support current leadership. I will also strive to create new leadership for the future of our POA. See you soon!

Appreciatively,

Jesse Jones, O.D.

POA President

Access Low Vision in Pennsylvania

I am so proud of what we at the POA have achieved this year. The POA has provided leadership development for over 40 members and established a new Diversity, Equity and Inclusion (DEI) Committee. Additionally, we have developed a new POPAC Proactive Optometry Initiative. After advocacy efforts this year, we've seen the successful passage of the Early Eye Drop legislation. We have even supported Salus University’s Ophthalmic Lasers Procedures for Anterior Segment certification course. You can register here. 

In addition to our established initiatives with the Pennsylvania Diabetic Eye Health Alliance (PDEHA)  and Children’s Vision Care Alliance (CVCA), the POA has now formed a Low Vision Awareness Committee. The overall purpose of the Low Vision Awareness Committee is to promote Low Vision awareness to Optometrists, Ophthalmologists, other health care providers, and the general public.

We are reminding our members that the standard of care for a patient with low vision is to refer to one of the many Optometrists in Pennsylvania who provide Low Vision rehabilitation.

So, what constitutes a referral for Low Vision services? No longer is the trigger for a referral to Low Vision a certain visual acuity, visual field or diagnosis. The standard of care now is to refer any patient who is struggling with at least one activity of daily living due to their vision loss. Examples could be: difficulty reading mail or pill bottles; trouble keeping up in school (at any age); concerns about driving; difficulty performing work-related tasks; difficulty traveling through unfamiliar environments; trouble reading books, magazines, or computers; inability to see favorites hobbies or past-times; difficulty seeing to provide self-care such as shaving; or difficulty seeing to perform housekeeping such as cooking and laundry. 

If you have provided the best optical correction, but your patient is still struggling, please refer to a Low Vision Optometrist. They can tackle the problem, not only by traditional glasses or contact lenses, but also by use of lighting, contrast, prisms, modified working distances, eccentric fixation, various forms of optical and electronic magnification, training with these devices and techniques, and referrals as needed to other supportive professionals. The earlier the Low Vision Optometrist can become involved, the more successful your patients are likely to be.

Of course, at no time should Low Vision care replace proper medical or surgical intervention. But do remember, Low Vision is an essential treatment modality to those with visual impairments. Also, please do not prejudge a patient’s ability to adapt to Low Vision care or pay for the services. Low Vision consultations are generally covered under a patient’s medical insurance. If not, other funding sources are available such as the Pennsylvania Bureau of Blindness and Visual Services. Get to know your local Low Vision Optometrists. They can guide you. Consider the Low Vision Optometrist a part of your team. They do the rehabilitation and you continue to be the patient’s primary eye care Optometrist.

If you are a POA member who provides Low Vision Rehabilitation, please make sure your AOA profile indicates you have a special emphasis in Low Vision Rehabilitation. Also, join the AOA Vision Rehabilitation Advocacy Network by signing up on the AOA website under practice > specialties > Vision Rehabilitation. By identifying yourself as a Low Vision Provider with your professional association, your colleagues and the general public will be able to find you on the AOA and POA “doctor finder” under Low Vision Emphasis. If you are not a Low Vision provider, search on the AOA or POA websites for a Low Vision Optometrist in your area.

I want to thank the POA for all its support. I ask members to stay involved, join PDEHA, join CVCA, and join or refer to POA Low Vision Optometrists. Become a keyperson. Join the Proactive Optometry Initiative. We all know that Optometry is the premier eye care profession in Pennsylvania. Let’s keep it that way. Great things are being planned for 2023, and I look forward to continued success for Optometry in Pennsylvania. 

Tracy Carpenter Sepich, O.D., M.S.

Doctor of Optometry

Masters of Science in Low Vision Rehabilitation

POA's bringing eye care to the children

One in five children has a vision problem. These vision problems may affect a child’s ability to learn, play, socialize, and develop positive self-esteem. The National Academies of Science, Engineering, and Medicine’s vision report underscores that comprehensive eye exams are “the gold standard in clinical vision care to most accurately identify and diagnose vision problems.” The American Optometric Association and Pennsylvania Optometric Association recommend children receive a comprehensive eye examination during the first year of life, between the ages of 3 and 5, before entering 1st grade, and annually thereafter. 

As Doctors of Optometry, we are uniquely qualified to assess and treat children’s vision and ocular health. This year, the POA is practicing what it preaches. The Association has held a long-time position that vision screenings, even by competent professionals, are not sufficient replacements for eye examinations by licensed optometrists.

In September, the POA, in cooperation with VSP Vision™ Eyes of Hope® and the Salvation Army Harrisburg Capital City Region, is providing approximately 200 free eye exams to children who would otherwise not receive care. The eye exams will take place on the 16th and 17th at the Salvation Army on 29th street. POA member optometrists, as well as supporting staff and students, will examine children and others of the underserved community in need of eye care as identified by the Salvation Army. VSP Vision™ Eyes of Hope® is providing the eye exam equipment, maintaining the medical records, and supplying glasses to those children in need, while the Salvation Army will provide follow-up care.

The POA’s initiatives for children’s vision do not end with the free eye exams—there are also ongoing discussions and education provided for free to school nurses, as well as free member materials to showcase the importance of eye examinations in the practice. Additionally, the POA supports current legislation to ensure all children receive the eye exams they deserve. 

Please remember to educate your patients, staff, schools, and community about children’s vision—reading teachers, pediatricians, and family physicians play vital roles in a child’s eye health also. You can teach this important community with the Kids Welcome Here posters and brochures, which are available to POA members free of charge, and Vision is Elementary posters, which are available for school nurses. Through the Children’s Vision Care Alliance, the POA has developed near point cards and a presentation to further educate school nurses of optometric care. The POA has developed all these materials for its members, but it needs you to get the word out. By joining the CVCA, you become part of a network of POA member optometrists dedicated to providing quality eye care to children. 

Thank you to the optometrists, staff, students, and other volunteers assisting in the September eye exams. Thank you to VSP Vision™ Eyes of Hope® and the Salvation Army Harrisburg Capital City Region for their cooperation.

Finally, a special thank you to the POA’s Ilene Sauertieg, who persisted to make the event, first conceived by our late executive director, Joe Ricci, into a reality.

Tracy Carpenter Sepich, O.D., MS
POA President

A strong POA is a diverse and inclusive POA

The Pennsylvania Optometric Association has a long history of providing member benefits ranging from advocacy to education. The Association provides a voice for optometry in Harrisburg and Washington, D.C., offers problem-solving and maintains ongoing relationships with third-party payers on behalf of our members. POA membership opens the door to premium opportunities with buying groups, investment strategies with Fischer Financial, insurance, discounts with Element Risk Management, HIPAA compliance solutions with Abyde, and consultative services with POA legal counsel. Additionally, the POA Electronic Claims Service helps you submit claims to third-party payers while also generating income to reduce membership dues.

When the COVID shutdown hit, we devised quality online education, which has continued as an option in addition to our revived in-person educational offerings, and we will continue to provide cutting-edge education as we explore scope expansion.

Through the Children’s Vision Care Alliance, we form relationships with school nurses statewide, and provide members with no-cost posters, brochures, and presentations to educate local schools and families on the importance of eye examinations. We have similar materials available to promote the need and accessibility of diabetic eye examinations by optometrists through the Pennsylvania Diabetic Eye Health Alliance. These programs keep our member optometrists involved and relevant in these essential areas of vision and eye care. 

We partner with the Pennsylvania Paraoptometric Association which provides education as well as networking and professional development opportunities for your staff. The AOA Paraoptometric Resource Center also provides staff training and certification.

We support our fourteen local optometric societies so members can attend meetings, obtain CE, network, and advocate locally. We work closely with the Pennsylvania Student Optometric Association to recruit new members and keep our initiatives current and relevant.

We update our members through email and this bi-monthly newsletter, which includes a classified section to assist members with practice and equipment sales and job searches.

A new addition to our association structure is a Diversity, Equity, and Inclusion (DEI) task force. As a result of responses to our 2021 membership survey, our new strategic plan calls for the creation of this DEI task force. This initiative is important in making sure all optometrists in Pennsylvania have a home in the POA. We need to make sure all optometrists know they are valued and welcomed. We want optometrists with a variety of backgrounds to contribute to the volunteer structure of the POA. We will be stronger as an association if we have a diverse community of members involved.

In an effort to recognize the AOA’s dedication to all people, at the 2021 AOA House of Delegates, the following statements were added to the Optometric Oath: “I WILL provide professional care for the diverse populations who seek my services, with concern, with compassion and with due regard for their human rights and dignity.  I WILL work to expand access to quality care and improve health equity for all communities.”

Please recognize we all have biases. Please educate yourself. Please attend local conversations about diversity in your community. Simply saying we are welcoming is not enough. When you are at a conference, sit next to someone who does not look like you. Stop into local optometry practices in various settings and invite them to your local society meetings.

I hope to foster a POA in which optometrists of all backgrounds, lifestyles, and practice styles know they belong, are safe and valued, and work together for our common goals. My hope is by nurturing a diverse and inclusive association, we will become better providers and serve a greater community with more acceptance and positive results.

Little things matter. Respect, even in small ways, matters.

If you have an interest in strengthening the POA by participating in the new POA DEI task force, contact me at tsepich@restoreeyecare.com or the POA office at mail@poaeyes.org. Thank you.

Tracy Carpenter Sepich, O.D., MS

POA President

Why do children need the POA?

Did you know there are approximately 1,745,000 students enrolled in Pennsylvania schools? Studies estimate 33% of these students are at risk for vision problems. That is approximately 576,000 students. Did you know 40% of students with learning disabilities have vision issues that affect learning? Did you know Pennsylvania schools spend 9K-15K per student on an IEP (Individualized Education Program), which is required for all special education students? Recent studies have found that children who are spending increasing time on electronic devices have a higher incidence of vision deficits that impact learning. The negative impact of children’s vision problems is likely to get worse if nothing changes. 

Children need the POA because we can uniquely provide the vision and eye care children need to succeed.  The POA's Children’s Vision Care Alliance (CVCA) has been busy educating optometrists, school nurses, and legislators on the importance of proper eye care for our children’s success in and out of the classroom.

Representative David Zimmerman has introduced HB 1343, which would require children in Pennsylvania to have a comprehensive eye health exam when entering school, in 4th grade, in 8th grade, and before qualifying for special education services. This bill currently has 40 co-sponsors with bipartisan support. It is currently in the Education Committee. We feel confident this bill can pass once it is out of committee. 

So, how can you help?  Please attend our Optometry at the Capitol Day in Harrisburg on Monday, March 28, where we will be lobbying for important issues. You are all invited to this investment in the future of Optometry. Please register here: https://pennsylvania.aoa.org/education-and-events/poa-lobby-day. Learn more about POA's legislative efforts and send a letter to your legislator by visiting the Advocacy page here: https://pennsylvania.aoa.org/advocacy.

In addition to contacting your legislators, please consider joining the POA Keyperson Committee or POPAC Fundraising Committee. You don’t need experience. You only need a passion for Optometry and helping our patients.

Finally, keep your eyes open for the new POA Proactive Optometry Initiative to help advance current and future Optometry-friendly legislation, like HB 1343. More information will be available soon!

Let's get back to the children, though. One study showed that when students who were identified with visual deficiencies received proper treatment, their grades significantly improved, whereas without proper treatment, these students continued to underperform, leading to a 12% reduction in wages.  Don’t you want to be part of the solution? Educate yourself. Educate your patients. Educate your local schools. Educate your legislators. Join the CVCA. Become a Keyperson. Support POPAC. If you don’t know where to start, call the POA and we will help you. Your children, and your children’s children, will thank you. I thank you. 

(Citations for the facts included in this editorial can be found on the POA Advocacy webpage.)

Tracy Carpenter Sepich, O.D.
POA President

Why are you a member of the POA?

The beginning of a new year is a perfect time for introspection. What is important to me? Why do I volunteer? Why is the POA important to me? What is important to the POA and its members? 

I know why I volunteer. I want, in my own way and in my own capacity, to make the world a better place. This year, as POA president, I hope I can use my talents to lead the POA to a better place for its members, volunteers, staff, and, most importantly, our patients. 

The POA has just completed its 2022-2026 Strategic Plan, which you can find on the POA website here: https://pennsylvania.aoa.org/about/2022-2026-poa-strategic-plan. Please take the time to read it. This reflects our members’ priorities and provides our road map to achieve success as an association.

In our strategic plan, you will see four strategic priorities that will be addressed by our volunteers and committee structure. These four priorities include: legislative efforts, children’s vision promotions, third party relationships, and finally, building a strong and engaged membership. So, now I start at the end. Today, I want to concentrate on strategic priority number four: “Leverage unused talents among optometrists in Pennsylvania to support the POA’s vision and mission.” We plan to drive membership and engagement for all Pennsylvania optometrists to contribute their unique talents to the POA by: creating a Diversity, Equity, and Inclusion (DEI) task force; increasing the membership numbers of corporate and private equity optometrists; increasing the membership numbers of newly licensed optometrists; and increasing member participation in POA committees.

To that end, we are offering a free leadership development program. It starts with a live meeting on Saturday, February 12 from 1:00 p.m. - 4:00 p.m. at the Hyatt Place in State College and wraps up on Sunday, October 9 from 8:00 a.m. - noon at Seven Springs Mountain Resort in Champion. All intervening events will be via Zoom. We have invited Renee Brauns, a long-time executive at the American Optometric Association, to lead our in-person events and guide us through the year. There is no cost to you for the program and no obligation, but space is limited. You can apply online here: https://pennsylvania.aoa.org/education-and-events/poa-2022-leadership-development. 

The live meetings will include presentations, interactive discussions, and networking opportunities. We will help you understand your leadership style to apply it within your practice, the POA, and everyday life. Our goal is for you to gain leadership skills and a better understanding of the POA, our leadership structure, and volunteer opportunities. If you want to make a difference in your profession or if you want to learn how to become a more effective leader, please apply.

Now, I ask you to please take a moment to consider what is important to you. What are your priorities? What is your vision for 2022? If you would like to see the POA achieve its strategic goals and reach its vision of “creating access to high-quality eye health and vision care for all citizens of Pennsylvania,” please apply to our leadership program. Please volunteer to serve on a POA committee. If you don’t know how to do that, contact me or the POA office. 

I have a vision for the POA. I know we can achieve our goals. That vision includes you. Please help your association by taking a risk and volunteering. The beautiful thing is by helping the POA, you will help yourself and your patients. I will always take that type of risk; everyone wins. Happy New Year.

Tracy C. Sepich, O.D., M.S. (she/her)

POA President

tsepich@restoreeyecare.com

A fond adieu

Have you ever noticed that once you finally figure something out, something changes and you have to adjust? It feels like the last year flew by so quickly. As an association, we started the year virtually, with the pandemic halting yet another Spring Congress. Questions of “will there be a vaccine” lapsed into “which one did you get?” And then there’s the mask thing. One would have thought that someone would have at least mentioned that people had to wear masks in healthcare facilities. Through it all, the POA moved forward. The Children’s Vision bill gained traction and now has 40 co-sponsors thanks to the hard work of our legislative team. The Keyperson Committee and Legislative Affairs Committee collaborated to make “How To” educational videos for legislator meetings. The Children’s Vision Care Alliance (CVCA) also grew, developed talking points, a pediatric near point card, and reached out to school nurses. We began working with ophthalmology on public health issues. The Early Drop Legislation will allow our patients to renew their drop prescription if they run out of drops before the end of the month. I hope that this blossoms into an ongoing collaboration between the eye care professions on matters of public health. 

Just as the strategic plan was set to begin implementation, the unthinkable occurred. We lost our executive director, Joe Ricci, to COVID-19. This virus is a cold, unfeeling malady that has left many to pass quietly on a ventilator without the comfort of family. It was a terrible blow to the POA and to me, personally. However, the Board of Directors are the guardians of the organization, and the Personnel Committee met immediately to develop a plan to maintain the integrity of the POA. With the full support of the Board, past presidents, and many others, we moved mountains: message triage, emergency meetings, and the formation of an executive director search committee—none of which would have happened so smoothly without the POA staff. I called the POA office so often that Deb and Ilene became Debilene. It was a rough few weeks, but we all pulled together to make it work. Our immediate past executive director, Dr. Charlie Stuckey, has stepped up and will be the interim director for the next six months. Over the years, he has been an ED, friend, and mentor for many of us and lends some calm to an otherwise high stress and tragic event. The search committee is actively moving forward to attempt to fill the shoes left behind by Joe. 

I have the unique perspective of not only moving the POA through a pandemic, but also losing our executive director to the virus. If there is one thing I learned about the POA during this time, it’s that it is a family and everyone is essential. Countless calls offering condolences, help, and guidance. It was an all hands on deck situation and the POA structure, once in place, moved forward like clockwork.

I want to thank the POA Board for all of their support and effort, the POA staff… well, for all that you do, and all of the members that offer their time and talents to this great organization. It’s time for me to say a fond adieu to my time at the helm. Expect big things next year. The foundations have been set and you are in some of the most capable, hard-working hands as we move into 2022.

Until soon,

Ed

Essential

Everything looked like we were moving out of the pandemic. Cases were lower, hospitalizations were down, and then variant began to take its toll on the vaccinated and unvaccinated alike. I wondered how optometry fit into all of this and the word ‘essential’ kept coming to my mind. 

Optometry is an essential component of the health care system, but what is essential to optometry? A healthy staff, a sound supply chain, and a professional organization to guide the profession through this unprecedented time. On the surface, the POA has delivered numerous updates regarding the practice of optometry during the pandemic. CDC guidelines, PA Department of Health and OSHA mandates were all brought to the forefront and shared with members to better keep ourselves, our staff, and our patients safe. 

But, as POA Executive Director Joe Ricci would say, “all of the action is under the duck.” In addition to what you see happening, there is even more happening behind the scenes. POA President-Elect Dr. Tracy Sepich is well into our strategic planning for the next three years. By this time, you have already received—and hopefully completed—a survey regarding the strategic initiatives of the POA for the next three years. We are a member-driven organization and rely on your input.

Through the efforts of the Third Party Center, Versant Health has become a business partner with the POA and will be at the fall meeting in October to answer your questions and listen to your concerns. From October 28 to 30, please join the POA and our exhibitors, business partners, and lecturers in making the most of our meeting. Registration and details can be found at https://pennsylvania.aoa.org/education-and-events/poa-fall-educational-conference. 

In other good news, the Children’s Vision Bill is garnering a lot of attention. Drs. Rich Christoph, Lori Gray, and the POA lobbyists have opened the eyes of legislators regarding the importance and value of this initiative. We expect that the legislature will come to the aid of the more than 30,000 children that are marginalized annually because they have an undetected vision disability. 

Although the Covid variant is looming and this year may end up being as strange and new as the last, I hope you’ll trust the POA to run an incredible educational conference this fall in Hershey. See you there!

Ed

Going with the flow

Who is the Pennsylvania Optometric Association? We are a group of optometrists representing and protecting the interests of our profession for our members in Pennsylvania. We are a member-run organization supported by a staff and executive director in our office in Harrisburg. Our Board of Directors is elected by the membership and is responsible for providing leadership to the many committees that make up the POA and for making the decisions necessary to protect and promote our profession in Pennsylvania 

The POA welcomes all optometrists in the state to belong to our association. All modes of optometric practice are welcome and represented in the POA. You are reading this editorial because you are member of the POA. Imagine what we could accomplish if every optometrist in Pennsylvania was a member. Imagine what we could accomplish if every member was actively involved in the POA. 

The many committees within the POA are staffed by volunteer optometrists who contribute their time and skills to support their profession. Many members, who cannot dedicate time, provide support through POPAC donations and/or act as keypersons with their legislators. Many are available as individuals who are called upon for specific issues that the POA must address. 

We need strength in numbers and involvement by members, especially in these unprecedented times. Please consider getting involved and encourage your non-member peers to join us. Call the POA office and speak to our executive director, Joe Ricci, Esq., to discuss a committee you would like to participate in or a skillset you have that could benefit our efforts. We need members from all demographics to help address the needs of all optometrists in Pennsylvania.

As POA president, I’ve experienced more firsts than I ever imagined. On July 18th, we held the first POA Board of Directors meeting via Zoom. Every effort to replicate a face-to-face meeting was taken and I feel the meeting went well. The Board, local society presidents (or their representatives), POA staff, our executive director, our lobbyists, and our POA attorney were in attendance. At every Board meeting, the actions that the Board has taken since the last official Board meeting are voted on. Each Board member is a DEO (division executive officer) of one or more committees within the POA and is responsible for delivering a written report prior to the meeting for distribution to all parties in attendance. At the meeting, Board members present a verbal report highlighting each committee’s activities and questions from those in attendance are answered. Local society presidents are expected to relay the information in these reports to their respective membership so that our members are well informed. Copies of these reports are available through the POA office by emailing Ilene@poaeyes.org. 

Another first during my presidency will be a Virtual House of Delegates this fall. The Board rescheduled this event from our cancelled Spring Congress to the Fall Educational Conference at Seven Springs this fall. We recently were informed that Seven Springs will be unable to host our event due to COVID-19 limitations imposed on them with regard to group size. The House of Delegates can be attended by any member and I encourage you to join albeit virtually. Information with regard to date and time will be forthcoming.

The continuing education that was scheduled at Seven Springs will now be available via webinars. The schedule and registration are located on the POA website. If you still need the required Act 31 credits, this webinar is being held on September 13th from 7:00 to 9:00 p.m.

Stay well and stay safe! Stay informed. Things are constantly changing both locally and nationally. Get involved if you can. Help the POA and AOA protect your profession. If this pandemic has taught us anything, it’s that we need to be prepared for unexpected threats to our profession and livelihood.

Sincerely,

David Evans, O.D.

POA President

Our new reality

 When I sat down to write this editorial, I was struck by how similar all of us optometrists are, yet, how different our current situations may be. My office reopened a couple of weeks ago and began seeing the medical eye care patients whose visits were postponed due to the stay at home order. Reopening required attaining PPE and equipping the physical office with sneeze guards, signage, and more. Staff education took place, and the process of contacting our patients and rescheduling them continues. We began and still are at a reduced schedule due to the new disinfection protocol following each patient’s visit to the exam room and optical. My exams are taking longer than usual because every patient wants to talk and catch up on what the last three months have been like for them. Everyone is wearing a mask and all of us hope all of this goes away soon. For many of the elderly, their eye exam was the first they have been out in public since the Governor’s stay at home order. 

Advice on steps to reopen our offices is abundant in our professional journals and online. The POA has provided guidance on a multitude of topics concerning the pandemic and optometry. Like you, some of it makes sense in my personal situation and some of it doesn’t. Some optometrists are now wearing scrubs, I gave up my tie. Some offices are washing every frame after it’s touched, others bought disinfection units. The large group practice in a neighboring town is having patients wait in their cars till the office is ready to see them, we are attempting to have our patients go directly to an exam room and bypass the waiting room. 

Whether you are an OD in private practice, group practice, specialty practice, or commercial practice, please know that the POA is here to support you. We will continue to take steps to protect and promote our profession. We are adapting to the new reality that social distancing may be here for a while. Investment in platforms that allow the POA to provide online CE to our members and Zoom meetings that take the place of in-person events is complete. Our first Zoom Board of Directors meeting with local society presidents has been scheduled for Saturday, July 18th. Continuing education webinars have been very successful and should our fall meeting in Seven Springs not be allowed to take place, the House of Delegates and continuing education courses will still happen, albeit virtually. 

I wish each of you best of luck and success in reopening your practices. Through this pandemic, we have proven that we are essential providers. We should be proud of the contribution Optometry has made to the health and welfare of the citizens of Pennsylvania. 

Unprecedented Times

I’ve got to be honest: when I figured out during the early years of my Board service that I would be president of the Pennsylvania Optometric Association in the year 2020, I thought “wow, how many ODs get to say that?” Both the POA and the AOA prepared for this unique year with big plans to promote our profession. None of us ever expected what we currently face both in our personal and professional lives. Like you, I am unsure of how long things will take to get back to normal and what the new normal will look like. The POA faces many of the same concerns and challenges as we wait to see what the future holds. However, as members of the POA, we are fortunate to have a strong professional organization that employs dedicated staff who truly care about us as individuals and as an organization. They are working from home to support and protect the POA in ways they never anticipated. As members of the POA, we are also fortunate to have a committee structure with volunteer ODs that are passionate about our profession.

Since the onset of COVID-19, the following optometry-centered events have been cancelled:

• Vision Expo East
• POA’s Lobby Day in Harrisburg
• POA/VSP eye exam clinic in Harrisburg
• POA’s Spring Congress in Gettysburg
• AOA’s Optometry’s meeting in Washington, D.C.
• POA’s CE in Italy trip

Keeping members updated during this time is the POA’s topmost priority. Here is an update on several of the committees and their current strategies:

THIRD PARTY COMMITTEE
This committee continues to work with the insurances we deal with every day. Their in-person meetings have been replaced with conference calls and Zoom events. They continue to advocate for us and work to resolve the ongoing issues between the insurance industry and optometrists as providers. Of utmost importance is their efforts to ensure that optometry is included in telehealth delivery of care to our patients.

LEGISLATIVE AFFAIRS COMMITTEE
The way the Pennsylvania Legislature functions during this pandemic has changed dramatically. There are no in-person meetings between our elected officials and constituents or lobbyists. Communication happens via email or phone calls. The LAC is working to update and modernize the optometric practice act as this pandemic has proven we are the primary eyecare profession and our diversity geographically increases patient access to urgent and emergency care.

Governor Tom Wolf has designated optometrists as life-sustaining providers. The Federal Government has recognized us similarly. We are on the frontline of urgent and emergency eye care statewide. The time is now to make your legislators aware of optometry’s expanded role during the pandemic and how we can continue to be a vital resource as we move out of this crisis.

CLINICAL EDUCATION COMMITTEE
The Clinical Education Committee has been working overtime to develop educational programs to assist members in renewing their licenses in 2020. The governor has allowed optometrists to obtain 100% of their credits for license renewal online for this renewal period only. The Committee sent out a survey to the membership and based on the responses have developed a series of webinars to include the core requirements for renewal and beyond. By now, you have hopefully participated in one or more of our web-based offerings. With the unexpected cancellation of our Spring Congress, the POA sustained a substantial loss of income. The Committee is doing what it can to give the membership what they need. Please support this endeavor when choosing the source of your online credits. Your financial support enables your professional organization to better support you!

As of now we are moving full steam ahead on our Fall Education Conference from October 23 to 24 at Seven Springs Mountain Resort. A few weeks ago, the POA emailed the membership a survey regarding continuing education this year and were encouraged by the number of members who still want to attend an in-person meeting this fall. Topics covering glaucoma, therapeutics, Act 31, and opioids for doctors still needing to meet the core requirements will be offered as well as additional educational topics.

I hope that you can appreciate all that the POA continues to do to support its membership. It is so very important to every Pennsylvania optometrist that the organization remains strong to support us in the coming weeks, months, and years. Your continued support of the POA and its programs is vital.

David Evans, O.D.

POA President

PCO/Salus University update

It seems appropriate that in the year of 2020, we should institute periodic updates on PCO/Salus University and enhance transparency between our state association and our state’s optometric college. Along that line, I will start providing an overview of President Dr. Mike Mittelman’s updates to our alumni board on Salus’ status and some of the upcoming PCO events. 

This year’s first meeting was on 1/19 and opened with a review of the upcoming class of 2020. There have been 582 applicants, which is a decline from 646 in 2019. This trend is reflective nationally with a decrease of approximately 15-20% and is also evident at the undergraduate level with a decline of approximately 11%. To align with this decrease and assure that quality students are accepted, the target size for the 2020 PCO class is 135, which has been deliberately reduced over the past four years. An interesting side note is a declining birth rate in the US since 2012; in 2018, there was a reduced birth rate of 2%, the lowest in 32 years.

Proactively, there is a proposed restructuring of Salus University into 3 colleges: PCO (600 students), Audiology (128 students), and a condensed College of Health Sciences, Education and Rehabilitation (CHER), which includes the programs of PA, OT, Biomedicine (PhD), Speech-Language pathology, post baccalaureate (for a total of 280 students) and a proposed orthoptics/prosthetics program. This will streamline the academic administration and allow stand-alone primary doctoral programs with master levels within single colleges.

Financially, the Centennial Campaign was successful in generating over $4.2 million in donations and the “Looking Out for Kids” event was also a success (>$135,000). It is scheduled this year on 11/14/2020 at the National Constitution Center (there is a solicitation for donated items for the silent auction). Student travel grants were approved for 11 students to represent Salus by presenting posters, papers, and participating in academic “challenge” bowls.

Politically, Salus continues to host visiting legislators. Most recently, House Majority Leader Rep. Bryan Cutler, Sen. Sharif Street, and Rep. Joanna McClinton. Dr. Mittelman along with the Salus faculty are very gracious hosts and provide an informative overview of our training that better educates our legislators. You are encouraged to invite and escort your legislator on a field trip to Salus; PCO will coordinate the arrangements.

Salus is lobbying PA to reinstitute a “line item budget” for $2 million to help reduce student tuition by $6-7,000. This was eliminated in 2008, with exception to the University of Pennsylvania’s veterinary program, since it was the only such program in the state (argument for reinstituting this budgeting for PCO). 

Upcoming events: Alumni gatherings at SECO (Atlanta, 3/06) and AOA (DC, 6/26). Salus is hosting a Woman’s Leadership Forum on 4/03. Consult Salus’ website for more events. Our next Alumni Board meeting will be on 7/12.

Respectfully submitted, 
Bob Owens, O.D., F.A.A.O.

Smart Talk with Scott LaMar on WITF

On Monday, March 28, Drs. Marianne Boltz and Gregory Caldwell joined radio host Scott LaMar for his show "Smart Talk." The doctors discussed Save Your Vision Month and the importance of yearly eye examinations, along with Kids Welcome Here and how to prevent digital eye strain. To listen to their interview online, visit
http://witf.vo.llnwd.net/o35/smarttalk/radiosmarttalk/RST_March282016.mp3.

Dr. Boltz explains the importance of the 20-20-20 rule on Smart Talk.

Dr. Caldwell smiles for the camera as Dr. Boltz discusses Kids Welcome Here.

Dr. Boltz and Dr. Caldwell have their photo taken by a WITF employee for their website.

Outside the green room, Dr. Boltz and Dr. Caldwell expressed their feelings about how the segment went.

Dr. Caldwell and Dr. Boltz with Scott LaMar after their segment.

Dr. Boltz and Dr. Caldwell pose for a photo outside the WITF building.

Salus welcomes new students from Qassim University

Salus University recently welcomed eight sixth-year optometry students from Qassim University in Saudi Arabia to its Elkins Park campus. As part of an agreement between the two universities, Qassim students attend lectures, participate in workshops and experience simulated patient encounters at the Salus University campus as part of their clinical curriculum.

For all eight students, this was their first time to the United States. While here they spent time in Philadelphia, New York and Washington D.C. The students believe their time spent at Salus University will give them an early clinical advantage, especially as optometry begins to grow as a profession in Saudi Arabia.

This is the second group of students Salus has welcomed from Qassim. Upon completion of their six years of study and a one-year internship, the students will obtain a Doctor of Optometry degree. Afterward, a majority of them plan in go into private practice.

Pictured from left to right: Abdulsalam Saleh Alyousef, Faisal Ali Alhamamah, Yousef Muneer Alharbi, Mohammad Saleh Aldhbiab, Abdulrahim Huwaydi Almutairi, Abdullah Salem Alharbi, Mohammed Nasir Elbaradei and Abdulmalik Ibrahim Alkharisi.

FAQs: Motorist Vision

From time to time questions come up about the interpretation of driving regulations as they pertain to vision. As chair of the POA’s Motor Vehicle Advisory Committee, as well as a member of PennDOT’s Medical Advisory Board, I am happy to research answers to these questions. While these answers are not legally binding, they have been presented to PennDOT’s legal counsel to formulate the best answer possible. Here are two questions which presented recently. 
Question: I am writing to you about the phrasing of what PennDOT requires for visual fields. Their letter states, and when you call PennDOT, they say: it has to be a Humphrey visual field. I use the Medmont, which is equivalent to the Humphrey. Is it possible that this regulation for visual fields can be written more clearly so that there is no confusion on the part of rehabilitative staff who may not understand that more than one or two pieces of equipment can measure 120° of visual field legitimately?
Regulation: Under the visual standards relating to the licensure of driving, § 83.3 e states “A person shall have a combined field of vision of at least 120° in the horizontal meridian, excepting the normal blind spots.” 
Answer: There is no specific testing instrumentation that is mentioned in the regulation. However, just as we might ask for a Kleenex® rather than a tissue, asking for a Humphrey visual field is simply asking for a visual field which will measure 120° of (contiguous) visual field. In those situations where interpretation of the data is in question, the PennDOT Motor Vehicle Advisory Board members who are familiar with visual fields will be asked to interpret the data. And while we are on the topic of visual fields, there are no waivers for visual fields of less than 120°.
Question: If after cataract surgery a patient has uncorrected VA of 20/20 OD, 20/100 OS, 20/20 OU and corrected VA 20/20 OD, 20/20 OS, 20/20 OU, are they required to wear corrective lenses to drive? 
Regulation: Under the visual standards relating to the licensure of driving, § 83.3 a, states “Driving without corrective lenses. A person with visual acuity of 20/40 or better combined vision may drive without corrective lenses.
   (1) If a person with visual acuity of 20/40 or better combined vision, however, has visual acuity of less than 20/40 in one eye, the vision in that eye shall be corrected to its best visual acuity.
   (2) A person with visual acuity of 20/40 or better combined vision and who has visual acuity of less than 20/40 in one eye, may drive without corrective lenses upon determination by a licensed optometrist or ophthalmologist that the person’s combined vision would not be improved by the use of corrective lenses.
Answer: The language in this section is a bit confusing. The intent of the language is that maximizing visual acuity should be attempted. However, it would be up to the examining eye doctor to determine if improving the vision in the uncorrected 20/100 eye would modify the function, which might determine the ultimate safety of the driver and the community in which that driver will operate a motor vehicle.
If you have any questions for Dr. Freeman concerning motorist vision, please email Kelsey@poaeyes.org with the subject “Motorist Vision.”

Senator Vogel's 2015 Kids Extravaganza

Senator Vogel's 2015 Kids Extravaganza was held at Community College of Beaver County in Monaca on Saturday, June 27 from 11:00 a.m. until 2:00 p.m.

Local POA member optometrists supported the event with tables including two very busy face painters that were a huge hit at the event.

Kids Welcome Here®, InfantSEE® and There is More to 3D were the table themes.

The POA members' mission was to explain with demonstration the need to have children's eyes examined at a very young age.

This was the sixth consecutive year for the event and the sixth consecutive year for local POA member optometrists to take part in it. An estimated 1500+ were in attendance.

Information and photos provided by Dr. Bud Lilly.

Join the POA for can’t-miss continuing education and fun

After a cold winter, spring has finally arrived and that means the POA Spring Congress is right around the corner. From May 15-17, the POA is pleased to be returning to one of our favorite venues: the beautiful Omni Bedford Springs Resort. With its turn-of-the-century architecture and rich history, as well as the lush grounds and amenities, it is the perfect backdrop for our annual meeting events. This meeting is packed with education, exhibits, business and social events that you won’t want to miss.

Continuing Education Hours
We are pleased to offer a well-rounded program of 13 continuing education credits, which includes 6 hours of TPA:
Conversations in Glaucoma – Dr. Joe Pizzimenti and Dr. Carlo Pelino
Essential Topical Formulary - Dr. Joe Pizzimenti and Dr. Carlo Pelino
Update on Oral Medications - Dr. Joe Pizzimenti and Dr. Carlo Pelino
Ocular Surface and Lid Marginal Disease – Dr. Thomas Kislan
Scleral Lenses: Speciality Lens Education for the Novice and Expert – Dr. James Deom
Scleral Lens Wet Lab – Dr. Thomas Kislan and Dr. James Deom
Primary Care Electrodiagnostics – Peter Kehoe, O.D.
Evidence-Based Eye Care of patients with Diabetes Mellitus – Peter Kehoe, O.D.
The POA would like to acknowledge Diopsys, MiboMedical and Valley Contax for their support of our continuing education program.

Business Partner Programs
The following programs will be presented at our Congress by POA Business Partners and we hope that you will attend.
On Friday, May 15 from noon-1:00 p.m., Dr. James Thimons will present The Growing Presence of Dry Eye Disease. This presentation is sponsored by Allergan. This non-credit program also includes lunch.
On Sunday, May 17 from 7:00-8:00 a.m., enjoy free breakfast and What do you know about the VSP® Global Premier Program? presented and sponsored by VSP. Come discover how the Premier Program can help you achieve your business goals by bringing you more patients, more value, and more support. During the presentation, attendees will learn: how to stand out to attract more valuable patients; make more by choosing innovative products that benefit you and your patients; and how to take it to the next level with exclusive offers and support.
If you haven’t registered for these sessions, please contact the POA office at (717) 233-6455. 

Exhibit Hall
As of April 20, the following exhibitors will be bringing a wide range of products and services to our hall this year. You will have ample time to visit their displays on Saturday, May 16 from 11:00 a.m.-2:30 p.m. during our lunch in the exhibit hall. Many will be giving away door prizes so bring your business cards. We encourage you to support the companies that support the POA by visiting their booths and welcoming their representatives into your offices.
ABB Optical Group
Alcon - Gold Business Partner
Allergan - Gold Business Partner
Beitler McKee
Bureau of Blindness and Visual Services
C&E Vision - Platinum Business Partner
Carl Zeiss Meditec
Carl Zeiss Vision
Coopervision
Diopsys, Inc.
Essilor Labs of America
Eyeficcient LLC
Eyenavision
Heidelberg Engineering
Hoya Vision Care
Maculogix - Silver Business Partner
MiboMedical
Novabay Pharmaceuticals
Optovue
PA Paraoptometric Association
Professional Eye Care Associates of America
Signet Armorlite
USI Affinity - Gold Business Partner
VSP Global - Platinum Business Partner
Walman Optical
We would also like to thank the Provision Group for their financial support of our Congress. 

Social Events
The POA is pleased to invite you, your family and staff to join us at our social events.
Our golf outing on Friday, May 15 is always one of the highlights at Bedford. The magnificent golf course is accessible right outside the front door of the resort and provides spectacular views of the surrounding area, as well as a challenging round of golf. The cost is just $140 and includes breakfast, greens and cart fees. Everyone is welcome to join this event from expert golfer to the weekend duffer, and our exhibitors have been invited also. 
Friday dinner is on your own so we encourage you to make reservations between 6:00 and 9:00 p.m. in the hotel’s main dining room, 1796 Room, or the pub. Check out our recent member update, which features a list of restaurants for wining and dining in Bedford. Doctors who have graduated since 2010 are invited to attend a special networking reception with the POA Board and local society presidents. Please see page 13 for details.
At 9:00 on Friday evening, POA President Dr. Rich Christoph and his wife Tammy invite you to join them for a relaxed evening of snacks, drinks and conversation. Spend the night talking with old friends and meeting new ones while taking in a spectacular view of the golf course and surrounding area. Everyone is welcome to join in this event.
Support your fellow members on Saturday night at 6:00 for the POA’s annual Awards Ceremony, where we will be honoring the 2015 award recipients. After the ceremony, we will be horsing around POA-style! Join us for a walk-around dinner featuring food, drinks and entertainment. Hedge your bets at our horse racing table or try your luck at the casino games. We invite the ladies in attendance to wear your “Derby hats” and participate in the fun of our hat contest. It will surely be a casual evening of fun with just a little competitiveness thrown in.

Wine and Dine in Bedford
As you know from perusing the POA Congress schedule, Friday evening has been left open for dinner on your own from 6:00-9:00 p.m. There are three wonderful restaurants located right on the Omni Bedford Springs property. There are also a number of options in and around downtown Bedford, just a 10-minute ride from the resort. The POA has compiled a list of restaurants (http://pennsylvania.aoa.org/Documents/PA/POA-2015-bedford-wineanddine.docx), both on and off property, for your consideration. Those located off the property are recommended by the Bedford Visitors Bureau. 
There are also boutiques, wine cellars, candy shops and antique shops located in downtown and we encourage you to visit if you have time. It’s a great place for families to explore while you are in business or education sessions, with plenty of parking and helpful shop owners to guide you around the main shopping area. 
Check out the bureau website at www.visitbedfordcounty.com for other ideas.