BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                AB 761
                                                                Page  1


        ASSEMBLY THIRD READING
        AB 761 (Roger Hernández)
        As Amended  January 23, 2012
        Majority vote 

         BUSINESS & PROFESSIONS            8-0               HEALTH      17-0
         
         ----------------------------------------------------------------- 
        |Ayes:|Hayashi, Bill Berryhill,  |Ayes:|Monning, Logue, Ammiano,  |
        |     |Allen, Butler, Eng, Hill, |     |Atkins, Bonilla, Eng,     |
        |     |Ma, Smyth                 |     |Garrick, Gordon, Hayashi, |
        |     |                          |     |Bonnie Lowenthal,         |
        |     |                          |     |Mansoor, Mitchell, Pan,   |
        |     |                          |     |V. Manuel Pérez, Silva,   |
        |     |                          |     |Smyth, Williams           |
        |-----+--------------------------+-----+--------------------------|
        |     |                          |     |                          |
         ----------------------------------------------------------------- 
         APPROPRIATIONS                17-0                              
         
         ----------------------------------------------------------------- 
        |Ayes:|Fuentes, Harkey,          |     |                          |
        |     |Blumenfield, Bradford,    |     |                          |
        |     |Charles Calderon, Campos, |     |                          |
        |     |Chesbro, Donnelly, Gatto, |     |                          |
        |     |Hall, Hill, Ammiano,      |     |                          |
        |     |Mitchell, Nielsen, Norby, |     |                          |
        |     |Solorio, Wagner           |     |                          |
        |     |                          |     |                          |
         ----------------------------------------------------------------- 
         SUMMARY  :  Allows optometrists to independently perform waived 
        clinical laboratory tests necessary for the diagnosis of conditions 
        and diseases of the eye.  Specifically,  this bill  :  

        1)Adds licensed optometrists to the list of persons who are 
          authorized under current law to perform a clinical laboratory test 
          or examination classified as waived under the federal Clinical 
          Laboratory Improvement Amendments (CLIA) of 1988.

        2)Includes, in the definition of "laboratory director" for purposes 
          of a clinical laboratory test or examination classified as waived, 
          a duly licensed optometrist serving as the director of a 
          laboratory, which only performs clinical laboratory testing as 
          authorized in 3), below.








                                                                AB 761
                                                                Page  2



        3)Allows optometrists who are certified to use therapeutic 
          pharmaceutical agents (TPAs) to perform a clinical laboratory test 
          or examination classified as waived under CLIA and as designated 
          under current law, as specified, necessary for the diagnosis of 
          conditions and diseases of the eye or adnexa, or if otherwise 
          specifically authorized by the Optometry Practice Act.

        4)Specifies that, for purposes of the Optometry Practice Act, 
          "adnexa" means ocular adnexa.

        EXISTING LAW  :

        1)Establishes CLIA under federal law, which regulates clinical 
          laboratories that perform tests on human specimens and sets 
          standards for facility administration, personnel qualifications 
          and quality control.

        2)Defines CLIA waived tests as simple laboratory examinations and 
          procedures that are approved by the Food and Drug Administration 
          (FDA) for home use, employ methodologies that are so simple and 
          accurate as to render the likelihood of erroneous results 
          negligible, or pose no reasonable risk of harm to the patient if 
          the test is performed incorrectly.

        3)Provides for the licensure and regulation of clinical laboratories 
          and their personnel by the State Department of Health Services 
          (now the Department of Public Health (DPH)), and requires clinical 
          laboratories to be operated under the supervision of a laboratory 
          director.

        4)Defines "laboratory director" to mean any person who is a duly 
          licensed physician and surgeon, or only for purposes of a clinical 
          laboratory test or examination classified as waived, is a duly 
          licensed naturopathic doctor, or is licensed to direct a clinical 
          laboratory and who substantially meets the laboratory director 
          qualifications under CLIA for the type and complexity of tests 
          being offered by the laboratory.

        5)Prohibits anyone from performing a clinical laboratory test or 
          examination classified as waived under CLIA unless the clinical 
          laboratory test or examination is performed under the overall 
          operation and administration of the laboratory director and the 
          test is performed by specified health care practitioners for 








                                                                AB 761
                                                                Page  3


          specified purposes.

        6)Establishes the Optometry Practice Act, administered by the State 
          Board of Optometry (Board), to regulate the practice of optometry.

        7)Defines the practice of optometry to include the prevention and 
          diagnosis of disorders and dysfunctions of the visual system, the 
          treatment and management of certain disorders and dysfunctions of 
          the visual system, and the provision of rehabilitative optometric 
          services.

        8)Requires optometrists to apply for a certificate from the Board 
          and meet specified requirements in order to be certified to use 
          TPAs and authorized to treat specified conditions and perform 
          certain procedures.

         FISCAL EFFECT  :  According to Assembly Appropriations Committee, this 
        bill results in additional fee-supported workload at the California 
        Department of Public Health (CDPH) in the range of $150,000 
        annually.   

         COMMENTS  :  According to the author, "State law prohibits the 
        performance of a clinical laboratory test or examination classified 
        as waived under the federal CLIA law unless the test or examination 
        is performed under the overall operation and administration of a 
        laboratory director...Optometrists are not considered or classified 
        as a laboratory director, therefore cannot administer these simple 
        CLIA waived tests related to the eye.

        "AB 761 will allow optometrists to administer simple CLIA waived 
        tests that are already within their scope of their practice.  This 
        legislation will designate optometrists as lab directors for CLIA 
        waived tests only and not for other more complex types of 
        testing?This will not expand the type or the number of tests that 
        would be considered CLIA waved."

        This bill allows licensed optometrists to perform waived tests and 
        to serve as the director of a lab that only performs tests 
        classified as waived and designated in current law for TPA-certified 
        optometrists, thereby allowing these optometrists to independently 
        perform these tests.
         

        Analysis Prepared by  :    Angela Mapp / B.,P. & C.P. / (916) 319-3301 








                                                                AB 761
                                                                Page  4



                                                               FN: 0003077