BILL ANALYSIS                                                                                                                                                                                                    

                                                                  AB 2683
                                                                  Page  1

          Date of Hearing:   April 20, 2010

                                 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  

        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
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                 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
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          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  

          However, current law only provides minimal regulatory safeguards  


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          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  


          Board of Optometry (sponsor)
          Advanced Eyecare, Inc.
          California Optometric Association
          Vision Service Plan (VSP)

          None on file.
          Analysis Prepared by  :    Marina Wiant / B.,P. & C.P. / (916)