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 facilitya 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 orand 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.