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.