BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 1359


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          Date of Hearing:  April 28, 2015


                   ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS


                                Susan Bonilla, Chair


          AB 1359  
          (Nazarian) - As Introduced February 27, 2015


          SUBJECT:  Optometry:  therapeutic pharmaceutical agents  
          certification:  requirements.


          SUMMARY:  Revises criteria for obtaining certification to  
          administer and prescribe therapeutic pharmaceutical agents  
          (TPAs) for licensed optometrists who graduated from an  
          accredited optometry school before or after 1996.  


          EXISTING LAW:


          1)Establishes the Optometry Practice Act which provides 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)Specifies that the Board shall, by regulation, establish  
            educational and examination requirements for licensure to  
            ensure the competence of optometrist to practice.  Only those  
            optometrists who have successfully completed educational and  
            examination requirements as determined by the Board shall be  
            permitted the use of TPAs.  (BPC § 3041.2)









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          3)States that in order to be certified to use TPAs, an  
            optometrist shall apply for a certificate from the Board and  
            meet all requirements imposed by the Board.  (BPC § 3041.3  
            (a))


          4)Authorizes the Board to grant a certificate to use TPAs to any  
            applicant who graduated from a California accredited school of  
            optometry prior to January 1, 1996, is licensed as an  
            optometrist, and meets specified requirements.  (BPC § 3041.3  
            (b))


          5)Authorizes the Board to grand a certificate to use TPAs to any  
            applicant who graduated from a California accredited school of  
            optometry on or after January 1, 1996, who is licensed as an  
            optometrist in California, and who meets specified  
            requirements.  (BPC § 3041.3 (c))


          6)Authorizes the Board to grant a certificate to use TPAs to any  
            applicant who is an optometrist who obtained his or her  
            license outside of California if he or she meets all of the  
            requirements for an optometrist licensed in California to be  
            certified to use TPAs. (BPC § 3041.3 (d))


          THIS BILL:


          7)Deletes certain requirements for an applicant for TPA  
            certification who graduated from a California accredited  
            school of optometry, prior to January 1, 1996, and is licensed  
            as an optometrist in the state, including, but not limited to,  
            completing a didactic course of at least 80 classroom hours,  
            as specified.
          8)Requires preceptorships to be with either a TPA certified  
            optometrist in good standing or a physician and surgeon board  








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            certified in ophthalmology in good standing.


          9)Requires such an applicant to complete a minimum of 80 hours  
            of directed and accredited education in ocular and systemic  
            diseases.


          10)Requires a preceptor to certify completion of the  
            preceptorship on a form approved by the board.


          11)Exempts and optometrist who graduated from an accredited  
            school of optometry on or after January 1, 1992, and before  
            January 1, 1996, from meeting specified requirements for the  
            issuance of a certificate to use TPAs, including the didactic  
            course of at least 80 classroom hours.


          12)Deletes exemptions for an optometrist who graduated from an  
            accredited school of optometry on or after January 1, 1992,  
            and before January 1, 1996, and instead requires them to meet  
            requirements for the issuance of a TPA certification.


          13)Authorizes the Board to grant a certificate to use  
            therapeutic pharmaceutical agents to an applicant who  
            graduated from a California accredited school of optometry, on  
            or after January 1, 1996, and is licensed as an optometrist in  
            the state if certain requirements are met, including, but not  
            limited to, completing 10 hours of experience with a Board  
            certified ophthalmologist.


          14)Deletes certain training and certification requirements for  
            an applicant of a TPA certification who graduated from a  
            California accredited school of optometry, on or after January  
            1, 1996, and is licensed as an optometrist in the state, and  
            would instead require such an applicant to pass all sections  








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            of the National Board of Examiners in Optometry's national  
            board examination or its equivalent in order to be granted a  
            TPA certification.


          15)Makes other technical changes.


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


          COMMENTS:


          16)Purpose.  This bill is sponsored by the  Board of Optometry  .   
            According to the author, "The Board of Optometry has  
            discovered that the didactic course that is required to be  
            completed prior to receiving the certification is no longer  
            offered by schools of optometry.  AB 1359 establishes a new  
            process where a preceptor offering the didactic course can  
            either be a TPA certified optometrist or ophthalmologist.   
            Post 1996, all optometrists have graduated with TPA  
            certification.  Those optometrists who graduate before 1996  
            have been left with few pathways to attaining TPA  
            certification because in 2009, TPA stand-alone courses have  
            been discontinued." 
          Background.  The TPA designation indicates that the optometrist  
            is certified to use therapeutic pharmaceutical agents and the  
            optometrist may treat certain conditions of the human eye, or  
            any of its appendages, with therapeutic pharmaceutical agents.  
             The optometrist may also perform certain procedures on the  
            eye.  


          According to the Board, there are approximately 500 TPA  
            certified optometrists in California.  In 1996, BPC § 3041.3  
            was added to define the criteria for TPA certification for  
            California licensed optometrists and for out-of-state licensed  








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            optometrists who desired to practice in California.   
            Optometrists who graduated from an accredited educational  
            program prior to 1996 were eligible to receive a TPA  
            certificate from the Board if they could show evidence of  
            completing several requirements including a preceptorship and  
            a minimum of 20 hours of continuing education.  


          Licensing Examination and Education Programs.  The addition of  
            BPC § 3041.3 prompted changes to the national examination for  
            optometrists, and the curriculum requirements of many  
            optometry programs.   According to the Board, education  
            programs now routinely include curriculum on TPA and the  
            licensing examination also includes information on TPA.   As  
            such, optometry students graduate with TPA certification and  
            there is no need for continuing education courses to be  
            offered.  This makes it difficult for those who completed  
            their education prior to 1996, but did not complete a TPA  
            continuing education course prior to 2009, to gain TPA  
            certification. 


          Preceptor Requirements.  This bill would require those  
            optometrists who did not receive continuing education prior to  
            2009 or who did not graduate from an educational program that  
            offered TPA focused training, to work with a preceptor in  
            order to meet the TPA requirement.  The preceptor can be a TPA  
            certified optometrist, who has been in practice for at least  
            two years, or a physician and surgeon board certified in  
            ophthalmology.  These professionals must be in good standing  
            with their licensing boards.  


          17)Prior Related Legislation.  SB 492 (Hernandez) of 2014, was  
            substantially similar to AB 492 of 2013.  NOTE: This bill was  
            held on the Assembly floor. 


          SB 492 (Hernandez) of 2013, would have permitted an optometrist  








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            to diagnose treat and manage additional conditions with ocular  
            manifestations, directed the Board to establish educational  
            and examination requirements and permitted optometrists to  
            perform vaccinations and surgical and non-surgical primary  
            care procedures.  NOTE: this bill was held in the Assembly  
            Committee on Business, Professions and Consumer Protection. 


          SB 821 (Senate Committee on Business, Professions and Economic  
            Development), Chapter 473, Statutes of 2013, clarified the  
            preferred name for a license is "optometrist license" and the  
            preferred name for certifications is "optometrist  
            certification(s)" and made conforming changes.


          AB 761 (Roger Hernandez), Chapter 714, Statutes of 2012,  
            provided that a laboratory director may include a licensed  
            optometrist and authorized an optometrist to perform certain  
            clinical laboratory tests or examinations classified as waived  
            under the Clinical Laboratory Improvement Act (CLIA). 


          ARGUMENTS IN SUPPORT: 


          The  Board of Optometry  (sponsor) writes in support, "The Board  
          has discovered that the didactic course that is required to be  
          completed prior to receiving the certification is no longer  
          offered by schools of optometry.  AB 1359 establishes a new  
          process where a preceptor offering the didactic course can  
          either be a TPA certified optometrist or ophthalmologist.  Since  
          2009, all optometrists graduate with TPA certifications, but  
          those optometrists who graduate before 1996 have been left with  
          few pathways to attaining TPA certification." 


          The  California Optometric Association  also supports the bill and  
          writes, "COA supports your efforts to create a clear and logical  
          avenue for TPA certification." 








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          ARGUMENTS IN OPPOSITION:


          None on file.


          REGISTERED SUPPORT:  


          Board of Optometry (sponsor)


          California Optometric Association




          REGISTERED OPPOSITION:  
          None on file.




          Analysis Prepared by:Le Ondra Clark Harvey, Ph.D. / B. & P. /  
          (916) 319-3301




















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