Amended in Senate April 6, 2015

Senate Bill No. 349

Introduced by Senator Bates

(Coauthors: Senators Berryhill and Nguyen)

February 24, 2015

An act to add Section 3070.2 to the Business and Professions Code, relating to begin delete optometry. end delete begin insert optometry, and making an appropriation therefor. end insert

LEGISLATIVE COUNSEL’S DIGEST

SB 349, as amended, Bates. Optometry: mobile optometric facilities.

The Optometry Practice Act provides for the licensure and regulation of the practice of optometry by the State Board of Optometry, and makes a violation of the act a crime. The act requires each licensed optometrist, before engaging in the practice of optometry, to notify the board in writing of the address or addresses where he or she is to engage in the practice of optometry and of any changes in his or her place of practice. begin insert Under existing law, end insert begin insert all moneys collected pursuant to the act, except where otherwise provided, are deposited in the Optometry Fund and continuously appropriated to the board to carry out the act. end insert

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This bill would authorize an optometrist to engage in the practice of mobile optometry with a mobile optometric facility, as defined, if the optometrist meets certain requirements, including, but not limited to, that the optometrist maintain a primary business office separate from the mobile optometric facility, as specified. The bill would also require an optometrist to certify that any information included on a printed copy of an original document to a patient is true, accurate, and complete. The bill would require that the mobile optometric facility, among other things, has a vehicle identification number. The bill would exempt mobile optometric facilities that are part of an extended optometric clinical facility, as defined, from these requirements.

end delete

begin insert This bill would define “mobile optometric facility” as mobile optometric equipment, including, but not limited to, a trailer or van that may be moved. The bill would limit ownership of a mobile optometric facility to a nonprofit or charitable organization, a governmental agency, or a school, as specified. The bill would require a mobile optometric facility, while providing services, to have access to, among other things, sufficient lighting around the perimeter of the work site from which the mobile optometric facility provides those services. The bill would require an owner of a mobile optometric facility to be responsible for certain things, including, but not limited to, maintaining the mobile optometric facility in good repair and in a clean and sanitary manner. The bill would also require the optometrist or owner of a mobile optometric facility to maintain and disclose patient records as specified. The bill would make these provisions operative on January 1, 2017. end insert

begin insert

This bill would require the board, by January 1, 2017, to promulgate regulations establishing a registry for mobile optometric facilities and shall set a registration fee at an amount not to exceed the costs of administration. Because this bill would increase those moneys deposited in a continuously appropriated fund, it would make an appropriation.

end insert begin insert

Because a violation of the act is a crime, this bill would expand the scope of an existing crime and would therefore impose a state-mandated local program.

end insert

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.

Vote: majority. Appropriation:  begin delete no end delete begin insert yes end insert . Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

begin insert

begin insert SECTION 1. end insert   

end insert

begin insert The Legislature finds and declares the necessity
of establishing end insert begin insert regulations for mobile optometric facilities in order
to help secure the availability of quality vision care services for
patients who receive care in remote or underserved areas and for
patients who need specialized types of cost-effective health care. end insert

begin delete SECTION 1. end delete
begin insert SEC. 2. end insert   

Section 3070.2 is added to the Business and Professions
Code, to read:

3070.2.  

(a) For purposes of this section, “mobile optometric
facility” means begin delete a self-contained unit housing end delete begin insert mobile optometric end insert
equipment, which may include a trailer or van, that may be moved,
towed, or transported from one location to another in which the
practice of optometry is performed as defined in Section 3041.
begin delete Mobile optometric facilities are limited to nonprofit, charitable
organizations with federal tax-exempt status as described in Section
501(c)(3) of the Internal Revenue Code (26 U.S.C. Sec. 501(c)(3))
or a mobile unit that is operated by a governmental agency. end delete begin insert end insert
begin insert “Mobile optometric facility end insert begin insert ” does not include an extended
optometric clinical facility, as defined in Section 1507 of Title 16
of the California Code of Regulations. end insert

begin delete

(b) The purpose of this section is to provide requirements for
mobile optometric facilities to provide optometric services as
authorized in Section 3041, in order to help secure the availability
of quality vision care services for patients who receive care in
remote or underserved areas and for patients who need specialized
types of cost-effective health care.

end delete begin delete

(c) An optometrist may engage in the practice of mobile
optometry provided that all of the following requirements are met:

end delete begin delete

(1) The optometrist maintains a primary business office, separate
from the mobile optometric facility, that meets all of the following
requirements:

end delete begin delete

(A) Is open to the public during normal business hours by
telephone and for purposes of billing services or access to patient
records.

end delete begin delete

(B) Is licensed to the optometrist or the employer of the
optometrist as a local business with the city or county in which
the primary business office is located.

end delete begin delete

(C) Is registered by the optometrist with the board.

end delete begin delete

(D) Is owned or leased by the optometrist or by the employer
of the optometrist.

end delete begin delete

(E) Is not located in or connected with a residential dwelling.

end delete begin insert

(b) The ownership of a mobile optometric facility shall be limited
to a nonprofit or charitable organization, a governmental agency,
or a school as provided in subdivision (e) of Section 1507 of Title
16 of the California Code of Regulations.

end insert begin insert

(c) The board shall promulgate regulations establishing a
registry for mobile optometric facilities and shall set a registration
fee at an amount not to exceed the costs of administration by
January 1, 2017.

end insert begin delete

(2)

end delete

begin insert (d) end insert  The optometrist begin delete maintains and discloses end delete begin insert or owner shall
maintain and disclose end insert patient records in the following manner:

begin delete

(A)

end delete

begin insert ( end insert begin insert 1) end insert  Records are maintained and made available to the patient
in such a way that the type and extent of services provided to the
patient are conspicuously disclosed. begin delete The disclosure of records shall
be made at or near the time services are rendered and shall be
maintained at the primary business office specified in paragraph
(1). end delete begin insert The optometrist shall notify the patient where his or her
records are stored and how the patient may access them. end insert

begin delete

(B)

end delete

begin insert ( end insert begin insert 2) end insert  The begin delete optometrist end delete begin insert individual maintaining the records end insert complies
with all federal and state laws and regulations regarding the
maintenance and protection of medical records, including, but not
limited to, the federal Health Insurance Portability and
Accountability Act of 1996 (Public Law 104-191).

begin delete

(C)  The optometrist keeps all necessary records for a minimum
of seven years from the date of service in order to disclose fully
the extent of services furnished to a patient, pursuant to Section
3007. Any information included on a printed copy of an original
document to a patient shall be certified by the optometrist as being
true, accurate, and complete.

end delete begin delete

(D)

end delete

begin insert (3) end insert  If a prescription is issued to a patient, records shall be
maintained for each prescription as part of the patient’s record,
including all of the following begin delete information about the prescribing
optometrist: end delete begin insert information. end insert

begin delete

(i) Name.

end delete begin delete

(ii) License number.

end delete begin delete

(iii) The place of practice and the primary business office.

end delete begin insert

(A) The optometrist’s name, license number, and contact
information

end insert begin insert

(B) The mobile facility’s owner, registration, and contact
information.

end insert begin insert

(C) The location at which optometric services were provided.

end insert begin delete

(iv)

end delete

begin insert (D) end insert  Description of the goods and services for which the patient
is charged and the amount charged.

begin delete

(E)

end delete

begin insert (4) end insert  For services provided at a schoolsite, a copy of consent by
the parent, guardian, or legal representative and referral or order
requesting optometric services from personnel in a school district
or county office of education, as defined in Section 49452 of the
Education Code and Section 591 of Title 5 of the California Code
of Regulations, shall be kept in the patient’s medical record.

begin delete

(3) The optometrist possesses and appropriately uses the
instruments and equipment required for all optometric services
and procedures performed within the mobile optometric facility.

(4) For mobile optometric facilities, the optometrist informs
patients in writing of any condition that requires follow-up care
or treatment.

(5) Mobile optometric facilities shall comply with all consumer
notice requirements of the board.

(6) There is a written procedure for follow-up care of patients
treated in a mobile optometric facility and that such procedure
includes arrangements for treatment by a local health care
professional.

(7) The mobile optometric facility shall arrange for emergency
medical care when indicated.

(8) The mobile optometric facility shall do all of the following:

(A) Have an access ramp or lift if services are provided to
disabled persons.

(B) Have adequate

end delete begin insert

(e) A mobile optometric facility shall comply with applicable
federal and state laws governing access for disabled individuals.

end insert begin insert

(f) When providing services, a mobile optometric facility shall
have access to all of the following:

end insert

begin insert (1) end insert begin insert   end insert begin insert Adequate end insert equipment and supplies for cleaning, disinfection,
and sterilization.

begin delete

(C) Have access to an

end delete begin insert

(2) Adequate instruments and equipment required for all
optometric services and procedures performed within the mobile
optometric facility.

end insert

begin insert (3) end insert begin insert   end insert begin insert An end insert adequate supply of begin delete clean end delete begin insert clean, end insert running begin delete water, including end delete
hot begin insert and cold end insert water.

begin delete

(D) Have ready access to toilet

end delete

begin insert (4) end insert begin insert   end insert begin insert Toilet end insert facilities.

begin delete

(E) Have a

end delete

begin insert (5) end insert begin insert   end insert begin insert A end insert covered, galvanized stainless steel or other noncorrosive
metal container for deposit of refuse and waste materials.

begin delete

(F)  Comply

end delete begin insert

(6) Sufficient lighting around the perimeter of the work site from
which the mobile optometric facility provides any services.

end insert begin insert

(g) An owner of an optometric facility shall be responsible for
all of the following:

end insert

begin insert (1) end insert begin insert   end insert begin insert Compliance end insert with the applicable requirements of the Vehicle
begin delete Code, and shall have a vehicle identification number for the mobile
optometric facility. end delete begin insert Code. end insert

begin delete

(G)  Maintain

end delete

begin insert (2) end insert begin insert   end insert begin insert Maintaining the mobile optometric facility end insert in good repair
and in a clean and sanitary manner.

begin delete

(H) Have a written policy

end delete

begin insert (3) end insert begin insert   end insert begin insert Establishing written policies end insert and procedures that include,
but are not limited to, all of the following:

begin delete

(i)

end delete

begin insert (A) end insert  Scope of services.

begin delete

(ii)

end delete

begin insert (B) end insert  Procedures for the performance of the services provided.

begin delete

(iii)

end delete

begin insert ( end insert begin insert C) end insert  Quality assurance.

begin delete

(iv)

end delete

begin insert (D) end insert  Infection control.

begin delete

(v)

end delete

begin insert ( end insert begin insert E) end insert  Medical record documentation of services begin delete provided, as
appropriate. end delete begin insert provided. end insert

begin delete

(vi) Transport for patients, including, but not limited to, a
method of transportation, special equipment, necessary personnel,
and protection from inclement weather.

end delete begin delete

(vii)

end delete

begin insert (F) end insert  Emergency response and evacuation plan for the mobile
unit.

begin delete

(I)  Maintain

end delete begin insert

(G) Arrangements for treatment by a local health care
professional.

end insert begin insert

(H) Patient emergency medical care.

end insert begin insert

(I) Written notification for patients of any condition that requires
follow-up care or treatment.

end insert

begin insert ( end insert begin insert 4) end insert begin insert   end insert begin insert Maintaining end insert a mobile unit services log that shall include,
but is not limited to, all of the following:

begin delete

(i)

end delete

begin insert ( end insert begin insert A) end insert  Patient record or identification number.

begin delete

(ii)

end delete

begin insert ( end insert begin insert B) end insert  Name, age, and sex of patient.

begin delete

(iii)

end delete

begin insert (C) end insert  Site, date, time, and as appropriate, duration of exam.

begin delete

(iv)

end delete

begin insert ( end insert begin insert D) end insert  Printed optometrist name and license number.

begin delete

(v)

end delete

begin insert (E) end insert  Signature or electronic signature, or the equivalent.

begin delete

(d)

end delete

begin insert (h) end insert  An optometrist who satisfies all of the requirements in this
section for the practice of optometry in a mobile optometric facility
shall not be required to comply with begin delete Section end delete begin insert Sections end insert 3070 begin insert and
3077 end insert in regard to providing notification to the board of each
location at which he or she practices.

begin delete

(e) Mobile optometric facilities that are part of an extended
optometric clinical facility, as defined in Section 1507 of Title 16
of the California Code of Regulations, are exempt from the
requirements of this section.

(f) The licensed primary business office shall be responsible
for obtaining approval for parking of the mobile optometric facility
as required by the local planning, zoning, and fire authorities. The
mobile unit shall be situated for safe and comfortable patient
access. The mobile unit shall comply with all local parking laws.
Any parking restrictions developed by a primary business office
or clinic for mobile units shall be strictly enforced by the primary
business office or clinic. The primary business office or clinic shall
ensure that there is sufficient lighting around the perimeter of the
site from which the mobile unit provides any services.

end delete begin insert

(i) This section shall become operative on January 1, 2017.

end insert

begin delete SEC. 2. end delete
begin insert SEC. 3. end insert   

No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution 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, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of
the Government Code, or changes the definition of a crime within
the meaning of Section 6 of Article XIII B of the California
Constitution.