BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON
          BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
                              Senator Jerry Hill, Chair
                                2015 - 2016  Regular 

          Bill No:            AB 1253         Hearing Date:     June 8,  
          2015
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          |Author:   |Steinorth                                             |
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          |Version:  |June 3, 2015                                          |
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          |Urgency:  |No                     |Fiscal:    |Yes              |
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          |Consultant|Sarah Huchel                                          |
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               Subject:  Optometry: license: retired volunteer service  
                                    designation.

          SUMMARY:  Establishes educational and training requirements for an  
          optometrist seeking a license with retired volunteer service  
          designation (volunteer license) who has not held an active  
          license in more than three years.   

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


          2)Defines the practice of optometry to include the prevention  
            and diagnosis of disorders and dysfunctions of the visual  
            system, the treatment and management of certain disorders and  
            dysfunctions of the visual system, and the provision of  
            rehabilitative optometric services, as specified.  (BPC §  
            3041) 


          3)Requires the Board to adopt regulations that require, as a  
            condition of license renewal, that all licensees submit proof  
            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  







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            satisfactory to the Board or by other means deemed equivalent  
            by the Board.  (BPC § 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 § 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 §  
            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 § 3147.6) 


          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 § 3151) 


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


          9)Requires the holder of a volunteer license to renew that  








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            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 § 3151.1(d)) 


          10)Requires an optometrist to complete, within two years  
            immediately preceding the license expiration date, either 40  
            hours of CE or, if the optometrist is certified to use  
            therapeutic pharmaceutical agents, 50 hours of CE.  (Title 16,  
            California Code of Regulations § 1536)


          This bill:

          1)Authorizes the Board to issue a volunteer license to an  
            optometrist who satisfies any of the following:

             a)   Holds a retired license issued within the last three  
               years, a license that has expired within the last three  
               years, or a license that is current and active.

             b)   Holds a retired license issued more than three but less  
               than five years ago, or a license that expired more than  
               three but less than five years ago and is not subject to  
               denial, as specified, if he or she certifies the completion  
               of 50 hours of CE.

             c)   Holds a retired license issued more than five years ago  
               or has a license that expired more than five years ago and  
               satisfies all of the following requirements:

               i)     Is not subject to a license denial for specified  
                 reasons.

               ii)    Applies to the Board.

               iii)   Pays the specified fees.

               iv)    Satisfactorily passes both of the following:

                  (1)       The National Board of Examiners in Optometry's  
                    Clinical Skills examination or other clinical  
                    examination approved by the Board.








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                  (2)       The Board's jurisprudence examination. 

          2)Provides that a volunteer license shall expire at midnight on  
            the last day of the licenseholder's birth month every two  
            years if not renewed.

          3)Makes clarifying and technical amendments.

          
          FISCAL  
          EFFECT:  This measure has been keyed "fiscal" by Legislative  
          Counsel. According to the Assembly Appropriations Committee,  
          dated April 22, 2015, costs to the Board are projected to be  
          minor and absorbable.  Any increased workload would be funded by  
          commensurate fee revenue.
          
          COMMENTS:
          
          1.Purpose.  This bill is sponsored by the  California State Board  
            of Optometry  .  According to the Author's office, this bill is  
            necessary because "there is no defined period by which an  
            optometrist must convert his/her license to a 'retired  
            volunteer' license. This is problematic because existing law  
            allows for a scenario in which an optometrist may not have  
            practiced for decades, but can quickly and easily decide to  
            obtain a retired volunteer license by filling out a form and  
            paying a fee to the State Board of Optometry. 

             "This poses consumer protection concerns, as consumers  
             rightfully expect that a volunteer optometrist is at least  
             relatively up to date on current standards, practices, and  
             education within the optometric field.  AB 1253 will uphold  
             reasonable consumer expectations that a volunteer optometrist  
             is qualified to offer services."

          2.Background.  The Board's mission is to protect the health and  
            safety of California consumers through licensing, education,  
            and regulation of the practice of optometry.  There are  
            currently over 8,800 licensed optometrists.  

          3.Retired and Volunteer Licenses.  SB 1215  (Emmerson, Chapter  
            359, Statutes of 2012) established both retired and volunteer  
            licenses.  Prior to these new categories, licensees entering  








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            retirement had to choose between keeping an active license and  
            complying with the attendant obligations (renewal fees, CE  
            requirements) or having their license placed on delinquent  
            status due to non-renewal until it was cancelled.  This  
            delinquency status is public and could be construed as an  
            indicator of professional impropriety, rather than just a  
            choice to not renew due to retirement.  SB 1215 allowed an  
            optometrist to pay a one-time fee to obtain a retired license,  
            which exempted the licensee from any further renewals and CE  
            requirements in exchange for no longer practicing optometry.   
            A retired optometrist could reactivate his or her license  
            within three years without penalty.   
          
            SB 1215 also allowed a retired optometrist to offer his or her  
            services for free at health fairs, vision screenings, and  
            public service eye programs by obtaining a volunteer license.   
            SB 1215 required that a volunteer optometrist renew the  
            license every two years and take the same CE requirements  
            required of active licensees.      

            While the law establishing a retired and retired volunteer  
            license was established in 2012, there are currently no  
            individuals with those designations because the Board is  
            currently completing the implementing regulations.    

          4.No Timeframe for Retired Volunteer Licenses.  In developing  
            regulations for SB 1215, the Board noted that current law does  
            not establish timeframes or competency requirements for  
            returning a retired optometrist to practice.  This could  
            permit someone who has not practiced in decades and not kept  
            up with changes in optometry to provide services to consumers.  
             The Board believes that 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, whether those services are paid  
            for or not.

          This bill establishes graduated education and training  
            requirements for an optometrist to obtain a volunteer license  
            based on his or her time out of practice.

          5.Policy Question Regarding Retired Licenses.  Current law  
            allows a volunteer license to be issued to either an  
            optometrist with an active or retired license.  This bill also  








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            allows a volunteer license to be issued to individuals who  
            have allowed their licenses to expire and have not obtained a  
            retired license, thereby bypassing the administrative  
            requirement that entails a separate application form and  
            payment.  Because retired licenses do not yet exist, this bill  
            will allow for a greater pool of potential volunteers because  
            it captures all optometrists who have ceased practice.

          However, current law is still nonsensical with regards to  
            obtaining a retired license.  Retired licenses may currently  
            only be issued to individuals immediately following active  
            practice, so if an individual decides to allow his or her  
            license to expire due to retirement, but later decides to  
            obtain a retired license, he or she must reactivate his or her  
            license (which, depending on the length of time between the  
            expiration and reactivation may include complete retesting of  
            optometry skills and knowledge), and then retire it.  The  
            Committee recommends amending these provisions to allow the  
            issuance of a retired license to an optometrist whose license  
            was in good standing prior to its expiration.

          6.Previous 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  
            reactive the license if certain conditions were met.  The bill  
            also required the board to issue a volunteer license 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.  

          7.Arguments in Support.  The  California State Board of Optometry   
            writes, "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, are licensed  
            and up to date on current practices within the field of  
            optometry.  AB 1253 will uphold this expectation by  
            establishing timeframes and expiration dates for retired  
            volunteer service licenses."








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          SUPPORT AND OPPOSITION:
          
           Support:  

          California State Board of Optometry (Sponsor)
          California Optometric Association

           Opposition:  

          None on file as of June 2, 2015.
                                      -- END --