BILL ANALYSIS                                                                                                                                                                                                    Ó



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

          Bill No:            AB 1359         Hearing Date:    June 15,  
          2015
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          |Author:   |Nazarian                                              |
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          |Version:  |February 27, 2015                                     |
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          |Urgency:  |No                     |Fiscal:    |Yes              |
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          |Consultant|Sarah Huchel                                          |
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               Subject:  Optometry: therapeutic pharmaceutical agents  
                            certification: requirements.


          SUMMARY:  Establishes a substitute method of qualifying for a  
          therapeutic pharmaceutical agent (TPA) certification. 

          Existing law:
          
          1)Provides, pursuant to the Optometry Practice Act (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)Authorizes an optometrist certified to use TPAs to also  
            diagnose and treat the human eye or eyes, or any of its or  
            their appendages, for specified conditions and perform certain  
            additional procedures.  (BPC § 3041 (b)(e))

          4)Establishes additional requirements to obtain a TPA  
            certificate for an applicant who graduated from optometry  
            school prior to January 1, 1996.  (BPC § 3041.3 (b)) 







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          5)Requires the Board to grant a TPA certificate to an 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:

             a)   Passes the National Board of Examiners in Optometry's  
               national board examination, or its equivalent, as  
               determined by the Board.

             b)   Of the total clinical training required by a school of  
               optometry's curriculum, successfully completed at least 65  
               of those hours on the diagnosis, treatment, and management  
               of ocular, systemic disease.

             c)   Is certified by an accredited school of optometry as  
               competent in the diagnosis, treatment, and management of  
               ocular, systemic disease to the extent authorized by this  
               section.


             d)   Is certified by an accredited school of optometry as  
               having completed at least 10 hours of experience with a  
               board-certified ophthalmologist.  (BPC § 3041.3 (c))

          This bill:

          1)Replaces the minimum requirement of 80 classroom hours in the  
            diagnosis, pharmacological, and other treatment and management  
            of ocular disease by either an accredited school of optometry  
            in California or a recognized residency review committee in  
            ophthalmology with a minimum requirement of 80 hours of  
            directed and accredited education in ocular and system  
            diseases.

          2)Requires an applicant to complete the 80 hours of education  
            prior to beginning a preceptorship.  

          3)Allows a TPA-certified optometrist in good standing to serve  
            as a preceptor. 

          4)No longer requires a preceptor to be authorized by an  
            accredited school of optometry in California or by a  
            recognized residency review committee. 








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          5)Strikes the requirement that the preceptorship be in either an  
            ophthalmologist's office or an optometric clinic.  

          6)Requires the preceptor to certify completion of the  
            preceptorship using a Board-approved form.

          7)Strikes the test requirement at completion of the 80 education  
            hours.

          8)Strikes the requirement of a minimum of 20 self-directed study  
            hours.  

          9)Clarifies that applicants seeking TPA certification who  
            graduated from a California accredited school of optometry  
            after January 1, 1996 pass all sections of the National Board  
            of Examiners in Optometry's national board examination. 

          10)Strike the following requirements for an applicant who  
            graduated from a California accredited school of optometry  
            after January 1, 1996:

             a)   Successfully completed at least 65 hours of the total  
               clinical training required by a school of optometry's  
               curriculum on the diagnosis, treatment, and management of  
               ocular and systemic disease.

             b)   Is certified by an accredited school of optometry as  
               competent in the diagnosis, treatment, and management of  
               ocular, systemic disease to the extent authorized by the  
               Act.

             c)   Is certified by an accredited school of optometry as  
               having completed at least 10 hours of experience with a  
               board-certified ophthalmologist.

          11)Makes technical and clarifying amendments.


          FISCAL  
          EFFECT:  This bill has been keyed "fiscal" by Legislative  
          Counsel.  According to the Assembly Appropriations Committee  
          analysis dated May 6, 2015, this bill would have negligible  
          state fiscal effect. 








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          COMMENTS:
          
          1.Purpose.  This bill is sponsored by the  California State Board  
            of Optometry  .  The author's office writes, "In 1996, BPC  
            Section 3041.3 was added to define the criteria for California  
            licensed optometrists and for out-of-state licensed  
            optometrists seeking licensure in California on the  
            requirements to be certified [to use therapeutic  
            pharmaceutical agents]. 

            "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 graduate with TPA certifications.  
            Those optometrists who graduated before 1996 have been left  
            with few pathways to attaining TPA certification; TPA  
            stand-alone courses were discontinued in 2009.  AB 1359  
            ensures that a pathway is established for any optometrist that  
            seeks TPA certification."

          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.  
              
            An optometrist may elect to pursue additional certifications  
            after initial licensure by the Board.  The following  
            certifications are currently offered:

             a)   Diagnostic Pharmaceutical Agents

             b)   TPA

             c)   TPA with Lacrimal Irrigation and Dilation

             d)   TPA with Glaucoma Certification 

             e)   TPA with Lacrimal Irrigation and Dilation and Glaucoma  








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               Certification.

            The TPA certification indicates that the optometrist is  
            certified to use certain pharmaceuticals to treat specified  
            conditions of the human eye or its appendages.  Prior to 1996,  
            a TPA certification was a stand-alone course.  However,  
            accredited optometry schools now include the requirements of  
            TPA certification in their core curriculum. 

            The Board became aware that schools were no longer offering a  
            TPA course and this bill creates an alternate educational  
            pathway to obtain a TPA for applicants who graduated prior to  
            1996.  The amendments remove schools' required involvement in  
            TPA certification, authorize an optometrist to be a preceptor,  
            strike reference to educational requirements that are now part  
            of the core curriculum, and allow an optometrist to take  
            different types of accredited education, including CEs, to  
            meet the education requirements.      

          3.Suggested Amendments.  

             a)   Current law makes an incorrect reference to a portion of  
               code that does not reference treatable conditions.  
            
              On page 3, line 5, delete "(d),"   

             b)   Current law requires 100 hours to obtain TPA  
               certification: 80 hours of classroom work and 20 hours of  
               self-study.  This bill presently requires only 80 hours  
               total; it is recommended that the total education hours be  
               equivalent.

          On page 4, line 6, delete "80" and add "100"

          4.Arguments in Support.  The Board writes in support, "On behalf  
            of the Board, I am writing to express support of AB 1359.   
            This legislation will set forth criteria for obtaining  
            certification to administer and prescribe TPA for applicants  
            who graduated from an accredited optometry school before  
            1996?. This criteria aims to help a small group of  
            optometrists who might not be certified have a pathway to do  
            so."
          









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          SUPPORT AND OPPOSITION:
          
           Support:  

          California State Board of Optometry (Sponsor)
          California Optometric Association

           Opposition:  

          None on file as of June 9, 2015.


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