BILL ANALYSIS ------------------------------------------------------------ |SENATE RULES COMMITTEE | AB 2683| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ------------------------------------------------------------ THIRD READING Bill No: AB 2683 Author: Hernandez (D) Amended: 7/15/10 in Senate Vote: 21 SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE : 7-0, 6/28/10 AYES: Negrete McLeod, Aanestad, Calderon, Corbett, Correa, Florez, Yee NO VOTE RECORDED: Wyland, Walters SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8 ASSEMBLY FLOOR : 72-0, 5/20/10 (Consent) - See last page for vote SUBJECT : Optometry SOURCE : Board of Optometry DIGEST : This bill authorizes optometrists to practice in long-term care settings such as skilled nursing facilities (nursing homes), psychiatric hospitals, and intermediate care facilities. ANALYSIS : Existing law: 1. Licenses and regulates the practice of optometry by the CONTINUED AB 2683 Page 2 Board of Optometry (Board) within the Department of Consumer Affairs (DCA). 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. 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 at any the following settings: A facility licensed by the Department of Public Health. A public institution, including, but not limited to, a school, community college, or correctional facility. A mobile unit operated by a governmental agency or nonprofit or charitable organization. The home of a non-ambulatory patient. The practice location of a licensed optometrist who is absent for a reason approved by the Board. 4. 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. 5. Specifies additional duties that an assistant may perform in the office of, and under the direct supervision of, an ophthalmologist or optometrist. 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 CONTINUED AB 2683 Page 3 the health facility or residential care facility, that meets all of the following requirements: Is open to the public during normal business hours by telephone and for purposes of billing services or access to patient records. 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. Is registered by the optometrist with the Board. Is owned or leased by the optometrist or by the employer of the optometrist. Is not located in or connected with a residential dwelling. B. Maintains or discloses patient records in the following manner: 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. 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 (HIPA) Act of 1996. 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. Records shall be maintained for each prescription as part of the patient's chart, including the optometrist's name and license number, the place of CONTINUED AB 2683 Page 4 practice or primary business office, and the description of the goods and services for which the patient is charged and the amount charged. 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. 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. 3. Defines certain terms for purposes of the above provisions, including: A. Health facility as specified in the Health and Safety Code, exclusive of a hospital, as defined. B. Residential care facility as a residential facility licensed by the Department of Social Services. 4. Authorizes 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. 5. Defines "setting" for purposes of # 4 above, to include, but not be limited to, any facility licensed by the Department of Public Health or the Department of Social Services. 6. Makes technical, clarifying and conforming changes. CONTINUED AB 2683 Page 5 Background Optometrists diagnose and treat vision problems and eye diseases and write prescriptions for eyeglasses, contact lenses, and medications. Optometrists are required to complete at least three years of study at an accredited college or university before beginning specialized optometry training. The specialized training is four years in duration and the optometry student must then pass written and clinical state board examinations prior to licensure. Currently, more than 6,500 optometrists practice in California. In 2007, AB 986 (Eng) authorized optometrists to practice at temporary locations in a similar fashion to statutes that authorize dentists to work at temporary practice locations, such as nursing homes, schools, and other public institutions. However, those provisions only authorized a limited term timeframe for the practice of optometry at these temporary locations; seven calendar days during a 30-day period and 54 days during the calendar year. Prior Legislation AB 986 (Eng), Chapter 276, Statutes of 2007, allowed the practice of optometry at temporary locations under certain conditions, established a retention period for optometrists to maintain patient records, and increased licensing fees. SB 929 (Polanco), Chapter 676, Statutes of 2000, among other things, authorized assistants working in the office of an optometrist or ophthalmologist, and under the direct supervision of an optometrist or ophthalmologist, to perform a number of optometric tests and procedures. FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes Local: Yes SUPPORT : (Verified 8/4/10) Board of Optometry (source) Advanced Eyecare, Inc. Chairman, UC Davis Eye Center Vision Service Plan CONTINUED AB 2683 Page 6 ARGUMENTS IN SUPPORT : According to the author: "California laws are vague and do not adequately address notification, standard of practice and record keeping requirements for optometrists who practice in health facilities. A definition of optometric care in non-traditional settings is needed in order to allow optometrists to provide this type of care in a way that will protect the public and increase access to care. Furthermore, due to low overhead costs and potentially high profit margins, increasing numbers of optometrists are providing this type of care either part-time or as a sole mode of practice. "Additionally, over the next several years and decades, Californian'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 to patients in these settings 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 practice location." ASSEMBLY FLOOR : AYES: Adams, Ammiano, Anderson, Arambula, Bass, Beall, Bill Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield, Bradford, Brownley, Buchanan, Caballero, Charles Calderon, Carter, Chesbro, Conway, Cook, Coto, Davis, De Leon, DeVore, Emmerson, Eng, Feuer, Fong, Fuentes, Fuller, Furutani, Gaines, Galgiani, Garrick, Gilmore, Hagman, Hall, Hayashi, Hernandez, Hill, Huber, Huffman, Jeffries, Jones, Knight, Lieu, Logue, Bonnie Lowenthal, Ma, Mendoza, Miller, Monning, Nestande, CONTINUED AB 2683 Page 7 Niello, Nielsen, Norby, V. Manuel Perez, Portantino, Ruskin, Salas, Saldana, Silva, Skinner, Smyth, Solorio, Audra Strickland, Swanson, Torlakson, Torres, Torrico, Tran, Yamada NO VOTE RECORDED: De La Torre, Evans, Fletcher, Harkey, Nava, Villines, John A. Perez, Vacancy JJA:mw 8/4/10 Senate Floor Analyses SUPPORT/OPPOSITION: SEE ABOVE **** END **** CONTINUED