BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 1253


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          Date of Hearing:  April 7, 2015


                   ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS


                                Susan Bonilla, Chair


          AB 1253  
          Steinorth - As Introduced February 27, 2015


          SUBJECT:  Optometry: license: retired volunteer service  
          designation.


          SUMMARY:  Limits the issuance of a license with a retired  
          volunteer service designation to an optometrist who holds a  
          retired license for less than three years, and requires the  
          holder of a retired license issued for more than three years to  
          meet certain requirements, including passing clinical and  
          jurisprudence examinations, in order for the State Board of  
          Optometry (Board) to issue a license with retired volunteer  
          service designation.     


          EXISTING LAW


          1)Provides, pursuant to the Optometry Practice Act, for the  
            licensure and regulation of optometrists by the Board within  
            the Department of Consumer Affairs.  (Business and Professions  
            Code (BPC) Section 3000 et seq.) 


          2)Defines the practice of optometry to include the prevention  
            and diagnosis of disorders and dysfunctions of the visual  
            system, and the treatment and management of certain disorders  








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            and dysfunctions of the visual system, as well as the  
            provision of rehabilitative optometric services, as specified.  
             (BPC Section 3041) 


          3)Requires the Board to adopt regulations that require, as a  
            condition to license renewal, that all licensees submit proof  
            satisfactory to the Board that they have informed themselves  
            of the developments in the practice of optometry occurring  
            since the original issuance of their licenses by pursuing one  
            or more courses of study satisfactory to the Board or by other  
            means deemed equivalent by the Board.  (BPC Section 3059)


          4)Provides that a license expires at midnight on the last day of  
            the licenseholder's birth month following its original  
            issuance and thereafter at midnight on the last day of the  
            licenseholder's birth month every two years if not renewed.   
            (BPC Section 3146)


          5)Authorizes an expired license to be renewed at any time within  
            three years after its expiration, and a retired license issued  
            for less than three years to be reactivated to active status  
            by filing an application for renewal, paying all fees, and  
            submitting proof of completion of the required number of hours  
            of continuing education (CE) for the last two years.  (BPC  
            Section 3147) 


          6)Authorizes the Board to reactivate or restore to active status  
            a license that is not renewed within three years after its  
            expiration, or a retired license issued for more than three  
            years, if specified requirements are met, including the  
            passage of both the National Board of Examiners in Optometry's  
            Clinical Skills examination, or other clinical examination  
            approved by the Board, and the Board's jurisprudence  
            examination.  (BPC Section 3147.6) 









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          7)Requires the Board to issue, upon application and payment of  
            prescribed fees, a retired license to an optometrist who holds  
            a current and active license; exempts a retired licensee from  
            CE requirements, and prohibits a retired licensee from  
            practicing optometry.  (BPC Section 3151) 


          8)Requires the Board to issue, upon application and payment of  
            prescribed fees, a license with retired volunteer service  
            designation to an optometrist who holds a retired license or a  
            license that is current and active.  (BPC Section 3151.1) 


          9)Requires an applicant for a license with retired volunteer  
            service designation to certify that  he or she has completed  
            the required number of CEs and that the sole purpose of the  
            license is to provide voluntary, unpaid optometric services at  
            health fairs, vision screenings, and public service eye  
            programs.  (BPC Section 3151.1(b) (c))


          10)Requires the holder of a retired license with volunteer  
            service designation to renew that license biennially, and to  
            certify that he or she has completed the CE requirements and  
            that the sole purpose of the license is to provide voluntary,  
            unpaid optometric services.  (BPC Section 3151.1(d)) 


          11)Limits the fee for a retired license, and the biennial  
            renewal fee for a retired license with volunteer designation,  
            to fifty dollars ($50).  (BPC Section 3152)  


          THIS BILL


          1)Specifies that the Board may issue a license with retired  
            volunteer service designation to an optometrist who holds a  








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            retired license for less than three years. 


          2)Requires the holder of a retired license issued for more than  
            three years to meet certain requirements, including the  
            passage of both the National Board of Examiners in Optometry's  
            Clinical Skills examination, or other clinical examination  
            approved by the Board, and the Board's jurisprudence  
            examination, in order for the Board to issue, upon application  
            and payment of the prescribed fee, a license with volunteer  
            service designation.  


          3)Clarifies that a license with retired volunteer service  
            designation expires at midnight on the last day of the  
            licenseholder's birth month every two years if not renewed.  


          FISCAL EFFECT:  Unknown.  This bill is keyed fiscal by the  
          Legislative Counsel. 


          COMMENTS


          1)Purpose.  This bill is sponsored by the Board.  According to  
            the author, "[This bill] is a consumer protection measure  
            which will ensure that retired optometrists are up to date and  
            current on standard optometric practices.  Existing law allows  
            for someone who practiced optometry decades ago to quickly  
            maintain a retired volunteer license simply by signing up and  
            paying a fee.  [This bill] will clarify that the Board will  
            only issue a 'retired volunteer license' to an applicant if  
            their regular optometrist license retired within the last  
            three years.  If it has been longer than three years, the  
            optometrist would have to reapply to the Board as a new  
            applicant.  Consumers hold a reasonable expectation that  
            optometrists at a health fair remain sufficiently educated in  
            standard and current practices and knowledge.  [This bill]  








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            will follow through on this expectation."


          2)Background.  Retired and Retired Volunteer Service Licenses.   
            SB 1215 (Emmerson), Chapter 359, Statutes of 2012, recently  
            established both retired licenses and licenses with retired  
            volunteer service designation for optometrists.  Prior to  
            these new license categories, licensees who were entering  
            retirement had to choose between keeping an active license,  
            and paying renewal fees, or having their license expire and  
            put on delinquent status before the license was cancelled.  In  
            addition, SB 1215 made it easier for retired optometrists to  
            volunteer by creating the volunteer service designation.   
            Regulations implementing the fees for these license  
            categories, set at twenty-five dollars ($25) for retired  
            licenses and fifty dollars ($50) for retired volunteer  
            licenses, became effective on April 1, 2014.  



          An optometrist with retired volunteer status is able to practice  
            solely for the purpose of volunteering his or her services at  
            health fairs, vision screenings, and public service eye  
            programs.  There is no limitation on the scope of services  
            that may be provided.  Active retired volunteers are required  
            to certify that they meet CE requirements, and must continue  
            to meet CE requirements as a condition of renewal.  

          Continuing Education Requirements.  BPC Section 3059 requires  
            the Board to adopt CE requirements for licensees, and Section  
            1536 of Title 16 of the California Code of Regulations  
            outlines those requirements.  Licensees are required to  
            complete 40 hours of continuing optometric education course  
            work within two years immediately preceding the license  
            expiration date, while optometrists certified to use  
            therapeutic pharmaceutical agents are required to complete 50  
            hours of CEs.  According to the Board, while a retired  
            licensee will have to certify that they have met these CE  
            requirements, this CE requirement is only applicable to the  








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            licensee's last renewal period, because retired licensees are  
            not required to complete CEs.  As a result, under existing  
            law, a retired licensee who has not maintained an active  
            license may be eligible for a retired volunteer license at any  
            point in time without completing any additional CEs. 

          No Time Frame for Retired Volunteer Licenses.  The Board notes  
            that because there is no time frame for a retired volunteer  
            license, it may allow a retired licensee who has not practiced  
            for decades and who has not kept up with any CE requirements  
            to convert their license to retired volunteer status and start  
            practicing again, which may pose a risk to consumers.   
            According to the Board, consumers who rely on retired  
            volunteer optometrists rightfully expect that the licensee is  
            up to date on current standards, practices, and education  
            within the optometry field, regardless of whether those  
            services are paid for or not.  

          Because these license categories are new, there are currently no  
            retired licensees who have been out of practice for more than  
            three years and thus would be ineligible to convert their  
            license to a retired volunteer license.  In addition, there is  
            no basis to determine whether allowing licensees who have been  
            on retired status for more than three years provide, or have  
            provided, substandard care to consumers.  However, the Board  
            seeks to prevent that possibility by limiting the time period  
            a licensee can be out of practice.  In addition, the Board  
            notes that the practice of optometry is subject to great  
            change, especially with regards to scope of practice, which  
            may increase the likelihood that someone who is out of  
            practice for longer than three years might not be able to  
            provide the same level of service, especially when there are  
            no limitations on the scope of services a volunteer can  
            provide.  
          3)Prior Legislation.  SB 1215 (Emmerson), Chapter 359, Statutes  
            of 2012, required the Board to issue a retired license to an  
            optometrist with a current and active license, prohibited the  
            holder of a retired license from engaging in the practice of  
            optometry, and authorized the holder of a retired license to  








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            reactive the license if certain conditions were met.  The bill  
            also required the board to issue a retired license with a  
            volunteer service designation to an optometrist with a retired  
            or current and active license, and required that applicant to  
            certify completion of specified continuing education hours,  
            and established renewal procedures for that license  
            designation.  


          ARGUMENTS IN SUPPORT.  The  California Board of Optometry  writes  
          in support, "Existing law allows for the holder of a retired  
          license to convert said license to a retired volunteer service  
          license at any time - even if their retired license is many  
          years old, and have not practiced optometry in several years.   
          Consumers have a reasonable expectation that an optometrist who  
          serves at a public health fair, for example, [is] licensed and  
          up to date on current practices within the field of optometry.   
          AB 1253 will uphold this expectation by establishing time frames  
          and expiration dates for retired volunteer service licenses.   
          This policy aims to increase consumer protection, which is  
          especially critical in the health field, specifically dealing  
          with one's vision and eyesight."     


          According to the  California Optometric Association  (COA), "This  
          measure clarifies the pathway for obtaining a 'retired  
          volunteer' license.  COA supports giving retired doctors of  
          optometry the ability to provide eye care in a volunteer  
          capacity for those in need." 



          ARGUMENTS IN OPPOSITION.  
          None on file.  


          POLICY ISSUES FOR CONSIDERATIONS.  According to the author, the  
          time period for a retired license to convert to a retired  
          volunteer license is limited to three years because that is the  








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          established time period for a license to be expired or on  
          retired status before it can be reactivated without having to  
          retake examinations.  However, the author may wish to consider  
          whether limiting the time period to three years may have the  
          inadvertent effect of limiting the pool of potential volunteers  
          who are able to provide competent services to those in need.   
          While the author raises a legitimate concern regarding the  
          amount of time someone can be out of practice and still engage  
          in practice, especially in light of the limited CE requirement,  
          the author may wish to consider whether such concerns about  
          keeping up to date with current practices could be mitigated by,  
          for example, an additional CE requirement.  As a result, the  
          author may wish to consider increasing the amount of time a  
          retired licensee can convert to a retired volunteer license,  
          without having to retake examinations, and contingent upon the  
          licensee's completion of the additional CE requirements.  This  
          may provide a balanced approach to ensuring that all consumers,  
          regardless of their ability to pay, are provided with competent  
          services, and promote access to care by limiting barriers to  
          volunteers. 


          


          SUGGESTED AUTHOR'S AMENDMENTS.  





          On page 2, line 6, strike "three" and insert "five"



          On page 2, line 10, strike "three" and insert "five"

          On page 2, line 15, insert the following:  "If the applicant has  
          held a retired license for more than three years, the applicant  








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          shall complete, and certify on the application that he or she  
          has completed, an additional 50 hours of formal continuing  
          optometric education course work."
          


          REGISTERED SUPPORT / OPPOSITION:




          Support


          State Board of Optometry (sponsor)


          California Optometric Association 




          Opposition


          None on file.




          Analysis Prepared by:Eunie Linden / B. & P. / (916) 319-3301
















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