BILL ANALYSIS AB 2683 Page 1 Date of Hearing: April 20, 2010 ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER PROTECTION Mary Hayashi, Chair AB 2683 (Hernandez) - As Amended: April 13, 2010 SUBJECT : Optometrists. SUMMARY : Authorizes the practice of optometry at a health care facility or residential care facility. Specifically, this bill : 1)Authorizes an optometrist to engage in the practice of optometry at any health facility or residential care facility, provided the optometrist: a) Maintains a primary business office, separate from the health facility or residential care facility, that meets all of the following requirements: i) Is open to the public during normal business hours by telephone and for purposes of billing services or access to patient records; ii) 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; iii) Is registered by the optometrist with the Board of Optometry (Board); iv) Is owned or leased by the optometrist or by the employer of the optometrist; and, v) Is not a residential dwelling. b) Maintains or discloses patient records in the following manner: i) 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 AB 2683 Page 2 primary business office; ii) 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; iii) The optometrist keeps all necessary records for a minimum of seven years from the date of service. Any information shall be certified by the optometrist as being true, accurate, and complete; iv) Records are be maintained for each prescription, if issued, as part of the patient's chart, including the optometrist's name and license number, the place of practice or primary business office, and the description of the goods and services for which the patient is charged and the amount charged; and, v) 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 be kept in the patient's medical record. c) Possesses and appropriately uses the instruments and equipment required for all optometric services and procedures performed within the health facility or residential care facility. 2)Exempts an optometrist from providing notification to the Board of each health facility or residential care facility, provided all requirements are met. EXISTING LAW : 1)Provides for the licensure and regulation of optometrists by the Board. 2)Requires an optometrist 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. AB 2683 Page 3 3)Exempts an optometrist from notifying the Board if he or she engages in temporary practice which is limited to seven calendar days during a 30-day period and 54 days during the calendar year. FISCAL EFFECT : Unknown COMMENTS : Purpose of this bill . According to the author's office, "Optometrists who practice in a variety of non-traditional settings, i.e., skilled nursing facilities, psychiatric facilities, intermediate care facilities, etc., and exceed the provisions for temporary practice have asked the Board to define for the purposes of setting minimum standards and clarification for optometrists who work in these settings. "Additionally, over the next several years and decades, California's, and the nations' baby boom generation are reaching age 65 and represent among the fastest growing population in the state and in the nation. It is projected that the number of elderly patients who live in assisted living facilities, traditional nursing homes, and various tiers of intermediate care is expected to double by year 2030. The concomitant expectation is that a great number of professional services, such as optometric services will be rendered for a non-ambulatory, or relatively immobile, percentage of the population. The Board wants to ensure that optometric services rendered in these settings and for these patients are provided in a manner as consistent as possible with the level of care that would be provided by the practitioner in his/her regular location for the practice of optometry." Background . Current law requires optometrists to notify the Board of all practice locations before beginning to practice at any location. In 2007, legislation was adopted to facilitate optometrists who practice at a given location on a temporary basis (e.g., nursing homes or prisons). AB 986 (Eng), Chapter 276, Statutes of 2007 allows optometrists to practice at temporary locations in a manner similar to a provision of law that facilitates dentists working at temporary practice locations, such as nursing homes, schools, and other public institutions. However, current law only provides minimal regulatory safeguards AB 2683 Page 4 for optometrists who practice in Long-Term Care Facilities, while an increasing number of optometrists are providing this type of care either part-time or as a sole mode of practice. This bill, sponsored by the Board, clarifies the minimum standards governing optometric services in non-traditional settings, including treatment documentation and preservation of records, to increase transparency regarding billing and services provided. REGISTERED SUPPORT / OPPOSITION : Support Board of Optometry (sponsor) Advanced Eyecare, Inc. California Optometric Association Vision Service Plan (VSP) Opposition None on file. Analysis Prepared by : Marina Wiant / B.,P. & C.P. / (916) 319-3301