BILL NUMBER: AB 2683	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JULY 15, 2010
	AMENDED IN SENATE  JUNE 14, 2010
	AMENDED IN ASSEMBLY  MAY 17, 2010
	AMENDED IN ASSEMBLY  APRIL 13, 2010

INTRODUCED BY   Assembly Member Hernandez

                        FEBRUARY 19, 2010

   An act to amend Sections 2544, 2553.6, 2559.4, and 2564 of, and to
add Section 3070.1 to, the Business and Professions Code, relating
to optometry.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 2683, as amended, Hernandez. Optometry.
   Existing law, the Optometry Practice Act, provides for the
licensure and regulation of optometrists by the State Board of
Optometry. A violation of the act constitutes a crime. Existing law
requires an optometrist, prior to engaging in the practice of
optometry, to notify the board in writing of the address or addresses
where he or she is to engage, or intends to engage, in the practice
of optometry.
   This bill would authorize the practice of optometry at a health
facility or residential care facility, as defined, provided the
optometrist meets specified requirements, including, but not limited
to, those related to maintaining a nonresidential primary business
office, patient access to, and disclosure of, patient records, and
specified recordkeeping requirements. The bill would exempt from the
address notification requirements to the board an optometrist who
practices in a health facility or residential care facility and who
meets the above requirements. Because a violation of those provisions
would constitute a crime, the bill would impose a state-mandated
local program.
   Existing law authorizes an assistant in the office of a physician
and surgeon or optometrist under the direct responsibility and
supervision of a physician and surgeon or optometrist to fit
prescription lenses. Existing law also specifies additional duties
that an assistant may perform in the office of, and under the direct
supervision of, an ophthalmologist or optometrist.
   This bill would authorize an assistant to fit prescription lenses
and perform those additional duties in any setting where optometry or
ophthalmology is practiced, under the direct responsibility and
supervision of a physician and surgeon, optometrist, or
ophthalmologist, respectively. The bill would define "setting" for
purposes of this provision to include, without limitation, any
facility licensed by the State Department of Public Health or the
State Department of Social Services. The bill would make conforming
changes to related provisions.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 2544 of the Business and Professions Code is
amended to read:
   2544.  (a) Notwithstanding any other provision of law, an
assistant in any setting where optometry or ophthalmology is
practiced who is acting under the direct responsibility and
supervision of a physician and surgeon or optometrist may fit
prescription lenses. Under the direct responsibility and supervision
of an ophthalmologist or optometrist, an assistant in any setting
where optometry or ophthalmology is practiced may also do the
following:
   (1) Prepare patients for examination.
   (2) Collect preliminary patient data, including taking a patient
history.
   (3) Perform simple noninvasive testing of visual acuity, pupils,
and ocular motility.
   (4) Perform automated visual field testing.
   (5) Perform ophthalmic photography and digital imaging.
   (6) Perform tonometry.
   (7) Perform lensometry.
   (8) Perform nonsubjective auto refraction in connection with
subjective refraction procedures performed by an ophthalmologist or
optometrist.
   (9) Administer cycloplegiacs, mydriatics, and topical anesthetics
that are not controlled substances, for ophthalmic purposes.
   (10) Perform pachymetry, keratometry, A scans, B scans, and
electrodiagnostic testing.
   (b) For the purposes of this section, "setting" includes, but is
not limited to, any facility licensed by the State Department of
Public Health or the State Department of Social Services.
   (c) Nothing in this section shall be construed to authorize
activities that corporations and other artificial legal entities are
prohibited from conducting by Section 2400.
  SEC. 2.  Section 2553.6 of the Business and Professions Code is
amended to read:
   2553.6.  The board shall deny any application for registration
under this chapter if any person licensed under Chapter 5 (commencing
with Section 2000), for whom the applicant, in accordance with
Section 2550, proposes to fill any prescription, has any proprietary
interest, or has designated or arranged for any other person to have
any proprietary interest in or with the applicant.
   The board may, in accordance with Section 2555, suspend, revoke,
or refuse to renew the certificate of any individual or firm under
this chapter, if such individual or firm, after the effective date of
this section, fills, or has filled, while holding a certificate
issued pursuant to this chapter, any prescription issued by any
person licensed under Chapter 5 (commencing with Section 2000) who
has any proprietary interest, or has designated or arranged for any
other person to have any proprietary interest, in or with such
individual or firm.
   Such penalties shall be in addition to, and not to the exclusion
of, any other remedies or penalties provided by law.
   "Proprietary interest," for the purposes of this section, means
any membership, coownership, stock ownership, legal or beneficial
interest, any other proprietary interest, or profit-sharing
arrangement, designated or arranged or held, directly or indirectly
in any form, in or with any individual or firm applying for
registration or registered under this chapter, except stock ownership
in a corporation which is listed on a stock exchange regulated by
the Securities and Exchange Commission if the stock is acquired in a
transaction conducted through such stock exchange.
   This section shall apply only to a dispensing optician required to
be registered pursuant to Chapter 5.5 (commencing with Section 2550)
and shall not be construed to modify Section 2557, or to affect the
fitting of prescription lenses by an assistant pursuant to Section
2544.
  SEC. 3.  Section 2559.4 of the Business and Professions Code is
amended to read:
   2559.4.  This article shall not apply to an assistant fitting
spectacle lenses pursuant to Section 2544 if the assistant is acting
under the direct responsibility and supervision of a physician and
surgeon or optometrist who engages in the practice of fitting
spectacle lenses for his or her patients.
  SEC. 4.  Section 2564 of the Business and Professions Code is
amended to read:
   2564.  The provisions of this article shall not apply to an
assistant fitting contact lenses while acting under the direct
responsibility and supervision of a physician and surgeon or
optometrist who engages in the practice of fitting contact lenses for
his or her patients under Section 2544.
  SEC. 5.  Section 3070.1 is added to the Business and Professions
Code, to read:
   3070.1.  (a) For purposes of this section, the following terms
have the following meanings:
   (1) "Health facility" means a health facility as defined in
Section 1250 of the Health and Safety Code, exclusive of a hospital
defined in subdivision (a) or (b) of that section.
   (2) "Residential care facility" means  any facility
  a residential facility, as defined in paragraph (1) of
subdivision (a) of Section 1502 of the Health and Safety Code, 
licensed by the State Department of Social Services  caring
for persons who cannot live alone but who do not need extensive
medical services. The services provided in these facilities vary
according to the needs of the individual, but typically include help
with medications and assistance with personal hygiene, dressing, and
grooming. Residential care facilities include, but are not limited
to, the   , including, but not limited to, the 
following:
   (A) Adult residential facilities.
   (B) Adult residential facilities for persons with special health
care needs.
   (C) Residential care facilities for the chronically ill.
   (D) Residential care facilities for the elderly.
   (E) Continuing care retirement communities.
   (F) Social rehabilitation facilities.
   (b) An optometrist may engage in the practice of optometry at any
health facility or residential care facility provided that all of the
following requirements are satisfied:
   (1) The optometrist maintains a primary business office, separate
from the health facility or residential care facility, that meets all
of the following requirements:
   (A) Is open to the public during normal business hours by
telephone and for purposes of billing services or access to patient
records.
   (B) Is licensed to the optometrist or the employer of the
optometrist as a local business with the city or county in which it
is located.
   (C) Is registered by the optometrist with the Board of Optometry.
   (D) Is owned or leased by the optometrist or by the employer of
the optometrist.
   (E) Is not  located in or connected with  a residential
dwelling.
   (2) The optometrist maintains or discloses patient records in the
following manner:
   (A) Records are maintained and made available to the patient in
such a way that the type and extent of services provided to the
patient are conspicuously disclosed. The disclosure of records shall
be made at or near the time services are rendered and shall be
maintained at the primary business office specified in paragraph (1).

   (B) The optometrist complies with all federal and state laws and
regulations regarding the maintenance and protection of medical
records, including, but not limited to, the federal Health Insurance
Portability and Accountability Act of 1996 (42 U.S.C. Sec. 300gg).
   (C) Pursuant to Section 3007, the optometrist keeps all necessary
records for a minimum of seven years from the date of service in
order to disclose fully the extent of services furnished to a
patient. Any information included on a printed copy of an original
document to a patient shall be certified by the optometrist as being
true, accurate, and complete.
   (D) If a prescription is issued to a patient, records shall be
maintained for each prescription as part of the patient's chart,
including all of the following information about the optometrist:
   (i) Name.
   (ii) Optometrist license number.
   (iii) The place of practice  or   and the
 primary business office.
   (iv) Description of the goods and services for which the patient
is charged and the amount charged.
   (E) A copy of any referral or order requesting optometric services
for a patient from the health facility's or residential care
facility's administrator, director of social services, the attending
physician and surgeon, the patient, or a family member shall be kept
in the patient's medical record.
   (3) The optometrist possesses and appropriately uses the
instruments and equipment required for all optometric services and
procedures performed within the health facility or residential care
facility.
   (c) An optometrist who satisfies all of the requirements in this
section for the practice of optometry at a health facility or
residential care facility shall not be required to comply with
Section 3070 with regard to providing notification to the board of
each facility or residential care facility at which he or she
practices.
  SEC. 6.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.