BILL ANALYSIS Ó Senate Appropriations Committee Fiscal Summary Senator Christine Kehoe, Chair AB 761 (Roger Hernandez) - Optometrists. Amended: June 4, 2012 Policy Vote: BP&ED 9-0 Urgency: No Mandate: No Hearing Date: July 2, 2012 Consultant: Jennifer Douglas This bill does not meet the criteria for referral to the Suspense File. Bill Summary: AB 761 would allow optometrists to independently perform waived clinical laboratory tests to aid in the diagnosis of conditions and diseases of the eye and would permit optometrists to serve as clinical laboratory directors. Fiscal Impact: Personnel costs of an estimated $128,000 in 2012-13, offset by fees payable to the Clinical Laboratory Improvement Fund for registration of optometrists to perform waived testing. Personnel costs of an estimated $124,000 annually, offset by fees payable to the Clinical Laboratory Improvement Fund. Background: Existing law provides for the regulation and licensure of clinical laboratories and clinical laboratory personnel by the State Department of Public Health (CDPH). Existing law prohibits the performance of a clinical laboratory test or examination classified as waived under the federal Clinical Laboratory Improvement Amendments (CLIA) of 1988 unless the test or examination is performed under the overall operation and administration of a laboratory director, as defined, and is performed by specified persons, including certain health care personnel. Waived tests are simple laboratory examinations and procedures cleared 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 performed incorrectly. Currently optometrists cannot legally perform certain tests during an office visit, such as the Rapid Pathogen Screening Adeno Detector, which tests for pink eye or a Tear Osmolarity Test, for the diagnosis of dry eye disease. AB 761 (Roger Hernandez) Page 1 Proposed Law: This bill permits optometrists to serve as clinical laboratory directors and specifies that optometrists can perform waived laboratory examinations or tests to aid in the diagnosis of conditions and diseases of the eye or ocular adexa. This bill would also allow optometrists who are certified to use therapeutic pharmaceutical agents to perform waived clinical laboratory tests or examinations necessary for the diagnosis of conditions and diseases of the eye. Related Legislation: SB 1246 (Negrete McLeod) Chapter 523/2010 included naturopathic doctors in the list of health care practitioners who could perform a clinical laboratory test or examination classified as waived under CLIA and designates naturopathic doctors as clinical laboratory directors for CLIA-waived tests only. Staff Comments: There are approximately 6,400 active, licensed optometrists in California. Optometrist wanting to perform CLIA-waived tests would need to register with Laboratory Field Services (LFS) under CDHP as clinical laboratories and pay an annual fee of $100. Because the bill expands the number of persons that can perform CLIA-waived tests additional staff will be needed by LFS to process applications and subsequent renewals each year. This analysis estimates personnel costs for two program technicians of $128,000 in 2012-2013 and $124,000 annually thereafter. If 20 percent of the current 6,400 active, licensed optometrists applied as a laboratory for waived testing, all costs would be offset by new fee revenue.