BILL ANALYSIS Ó
SB 492
Page 1
SENATE THIRD READING
SB 492 (Ed Hernandez)
As Amended August 19, 2014
Majority vote
SENATE VOTE :25-5
BUSINESS & PROFESSIONS 8-1 APPROPRIATIONS 10-1
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|Ayes:|Bonilla, Jones, |Ayes:|Gatto, Bocanegra, |
| |Dickinson, Eggman, | |Bradford, |
| |Gordon, Mullin, Skinner, | |Ian Calderon, Campos, |
| |Wilk | |Eggman, Gomez, Holden, |
| | | |Quirk, Weber |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Maienschein |Nays:|Ridley-Thomas |
| | | | |
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SUMMARY : Authorizes an optometrist to administer influenza and
herpes zoster virus (shingles) immunizations for persons 18
years of age and older after completing a training program.
Specifically, this bill :
1)Requires the Board of Optometry (Board) to grant an
optometrist, certified as specified, a certificate for the use
of certain immunizations once the optometrist meets the
following requirements:
a) Completes an immunization training program endorsed by
the federal Centers for Disease Control and Prevention
(CDC) that, at a minimum, includes hands-on injection
technique, clinical evaluation of indications and
contraindications of vaccines, and the recognition and
treatment of emergency reactions to vaccines, and maintains
that training;
b) Is certified in basic life support; and,
c) Complies with all state and federal recordkeeping and
reporting requirements, including providing documentation
to the patient's primary care provider and entering
information in the appropriate immunization registry
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designated by the immunization branch of the State
Department of Public Health (DPH).
2)Defines "immunization" for purposes of this bill to mean the
"administration of immunizations for influenza and herpes
zoster virus in compliance with individual Advisory Committee
on Immunization Practices (ACIP) vaccine recommendations
published by the CDC for persons 18 years of age or older.
3)Requires the Board to set the fee by regulation, which shall
not exceed $100, for the issuance and renewal of an
immunization administration certificate at the reasonable cost
of regulating immunization certified optometrists.
4)Makes other technical or non-substantive amendments.
5)Declares that no reimbursement is required by this bill
because the only costs that may be incurred by a local agency
or school district will be incurred because this act creates a
new crime or infraction, eliminates a crime or infraction,
changes the penalty for a crime or infraction, or changes the
definition of a crime.
EXISTING LAW :
1)Establishes the Board within the Department of Consumer
Affairs, which licenses optometrists and regulates the
practice of optometry. (Business and Professions Code (BPC)
Section 3010.5)
2)Authorizes the Board to establish educational and examination
requirements for licensure. (BPC Section 3041.2)
3)Authorizes a licensed pharmacist administer immunizations
pursuant to a protocol with a prescriber. (BPC Section 4052)
4)Authorizes a licensed pharmacist to independently initiate and
administer vaccines listed on the routine immunization
schedules recommended by the ACIP, in compliance with
individual ACIP vaccine recommendations, and published by the
CDC for persons three years of age and older. (BPC Section
4052.8(a))
5)Requires a licensed pharmacist, in order to initiate and
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administer an immunization, to do the following:
a) Complete an immunization training program endorsed by
the CDC or the Accreditation Council for Pharmacy Education
that, at a minimum, includes hands-on injection technique,
clinical evaluation of indications and contraindications of
vaccines, and the recognition and treatment of emergency
reactions to vaccines, and shall maintain that training;
b) Be certified in basic life support; and,
c) Comply with all state and federal recordkeeping and
reporting requirements, including providing documentation
to the patient's primary care provider and entering
information in the appropriate immunization registry
designated by the immunization branch of DPH.
6)Authorizes a pharmacist to initiate and administer epinephrine
or diphenhydramine by injection for the treatment of a severe
allergic reaction. (BPC Section 4052.8)
FISCAL EFFECT : According to the Assembly Appropriations
Committee:
1)One-time costs of approximately $150,000 per year for the
first two years for exam development, Information Technology
changes, regulations, licensing, enforcement, and program
oversight.
2)Ongoing costs for enforcement and program oversight are
expected to be approximately $100,000.
3)Increased revenues of $50,000 associated with an increase in
certification fees currently authorized for treatment of
glaucoma, as this certification is necessary to pursue the
advanced certification created by this bill.
COMMENTS :
1)Purpose of this bill. This bill would authorize an
optometrist to administer influenza and herpes zoster virus
(shingles) immunizations to persons 18 years of age and older
after completing a training program endorsed by the CDC. This
bill is sponsored by the California Optometric Association.
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2)The practice of optometry. An optometrist (Doctor of
Optometry or O.D.) is an independent primary health care
professional for the eye. Optometrists examine, diagnose,
treat, and manage diseases, injuries, and disorders of the
visual system, the eye, and associated structures, as well as
identify related systemic conditions affecting the eye.
O.D.'s are authorized to prescribe certain medications, low
vision rehabilitation, vision therapy, spectacle lenses,
contact lenses, and perform certain surgical procedures.
Optometrists have a narrower scope of practice than do
ophthalmologists (physicians that specialize in treating the
eye), but are held to the identical standard of care for the
same treatments they provide.
In order to be licensed to practice by the Board, an
individual must obtain an O.D. degree, pass the three-part
National Board of Examiners in Optometry examination, and the
California Optometric State Law Examination. There are
currently more than 9,100 optometrists in practice in
California.
Optometrists are trained to diagnose mild to severe eye
problems such as serious eye infections, inflammations of the
eye, trauma, foreign bodies and glaucoma (pressure inside the
eye). They also examine the eye for vision prescription and
corrective lenses. Optometrists may also pursue any of five
additional state certifications to perform certain advanced
procedures: use of diagnostic pharmaceutical agents; use of
therapeutic pharmaceutical agents (TPA); lacrimal irrigation
and dilation for individuals over the age of 12 in addition to
the TPA certification; diagnosis and treatment of open angle
glaucoma for adults in addition to the TPA certification; and
a combination of TPA, TPL and TPG certifications.
3)Immunizations. This bill would authorize a TPA-certified
optometrist to administer immunization shots to persons 18
years of age and older for influenza and herpes zoster virus
(shingles). As a prerequisite, the optometrist must complete
a CDC-approved training program that includes hands-on
injection technique, clinical evaluation of indications and
contraindications of vaccines, and the recognition and
treatment of emergency reactions to vaccines. The optometrist
must also be certified in basic life support and comply with
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state and federal recordkeeping and reporting requirements.
Analysis Prepared by : Hank Dempsey / B., P. & C.P. / (916)
319-3301
FN: 0004994