BILL ANALYSIS �
Senate Appropriations Committee Fiscal Summary
Senator Kevin de Le�n, Chair
SB 492 (Hernandez) - Optometrist: practice: licensure.
Amended: May 8, 2013 Policy Vote: B&P 8-0
Urgency: No Mandate: Yes
Hearing Date: May 23, 2013 Consultant: Brendan McCarthy
SUSPENSE FILE.
Bill Summary: SB 492 would expand the scope of practice for
optometrists.
Fiscal Impact:
One-time costs of about $950,000 over two years to revise
regulations and certify additional optometrists to use
therapeutic pharmaceutical agents by the California Board of
Optometry (State Optometry Fund).
Ongoing costs of about $350,000 for certifications and
enforcement activities (State Optometry Fund).
Increased fee revenues of about $80,000 over the first two
years and about $10,000 per year thereafter for additional
certifications (State Optometry Fund).
Indeterminate impact on state health care programs, such as
CalPERS and Medi-Cal. See below.
Background: Under current law, optometrists are licensed and
regulated by the California Optometry Board. Current law
establishes the scope of practice for optometrists and indicates
what services an optometrist is authorized to provide to
patients. In general, optometrists are trained and authorized to
diagnose mild to severe eye problems, to prescribe corrective
lenses, and provide other, specified services. An optometrist
may apply for certification to provide certain additional
services, such as the treatment of primary open angle glaucoma.
Proposed Law: SB 492 would expand the scope of practice for
optometrists.
Specific provisions of the bill expanding the scope of practice
SB 492 (Hernandez)
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for optometrists:
Add the provision of habilitative optometric services;
Add eyelid disorders to the list of conditions that can be
treated;
Eliminate current limits on the treatment of ocular
inflammation (nonsurgical in cause);
Eliminate the current list of therapeutic agents that a
certified optometrist may prescribe and authorize a
certified optometrist to use all drugs approved by the
Federal Drug Administration for treating eye conditions;
Authorize an optometrist to order laboratory and diagnostic
tests;
Authorize an optometrist to prescribe certain vaccines;
Authorize an optometrist to test for and diagnose diabetes,
hypertension, and hypercholesterolemia.
Related Legislation:
SB 352 (Pavley) authorizes certain medical professionals to
supervise medical assistants. That bill is in the Assembly.
SB 491 (Hernandez) would expand the scope of practice for
nurse practitioners. That bill is on the Senate Floor.
SB 493 (Hernandez) would expand the scope of practice for
pharmacists. That bill is on this committee's Suspense File.
Staff Comments: By expanding the scope of practice for
optometrists, this bill will allow optometrists to provide more
care to patients. Additional care provided by optometrists may
increase overall utilization of health care, to the extent that
patients are currently unable to get care from other
practitioners, such as ophthalmologists or primary care
physicians.
On the other hand, patients may substitute care from an
optometrist for care from another practitioner. In addition, to
the extent that patients are currently unable to access primary
care services, those patients may ultimately end up receiving
care in another setting, such as an emergency room, urgent care
facility, or community clinic. Care provided in those settings
is likely to be more costly than primary care (for those
patients who require such care).
Therefore, the overall impact on utilization and cost of health
care from this bill cannot be determined and any potential
impact on state health care programs, such as CalPERS and
SB 492 (Hernandez)
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Medi-Cal, cannot be determined.
The only costs that may be incurred by a local agency relate to
crimes and infractions. Under the California Constitution, such
costs are not reimbursable by the state.