BILL ANALYSIS Ó
SB 622
Page 1
Date of Hearing: June 28, 2016
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Rudy Salas, Chair
SB 622(Hernandez) - As Amended June 22, 2016
SENATE VOTE: 33-4
SUBJECT: Optometry
SUMMARY: This bill expands the scope of practice for
optometrists to include the use noninvasive, nonsurgical
technology to treat a condition authorized by the Optometric Act
(Act), perform laser and minor procedures, and administer
certain vaccines.
EXISTING LAW:
1)Establishes the California Board of Optometry (Board), within
the Department of Consumer Affairs (DCA), which licenses
optometrists and regulates the practice of optometry. (BPC §
3010.5)
2)Authorizes the Board to establish educational and examination
requirements for licensure. (BPC § 3041.2)
3)Defines the practice of optometry as follows:
a) Prevention and diagnosis of disorders and dysfunctions
of the visual system;
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b) Treatment and management of certain disorders and
dysfunctions of the visual systems;
c) Provision of rehabilitative optometric services;
d) Examination of the human eyes;
e) Determination of the powers or range of human vision;
f) Prescribing or directing the use of any optical device
in connection with ocular exercises, visual training,
vision training or orthoptics;
g) Prescribing of contact lenses and glasses; and,
h) Use of topical pharmaceutical agents for the purpose of
the examination of the human eye or eyes for any disease or
pathological condition. (BPC § 3041)
4)Specifies that an optometrist who is certified to use
therapeutic pharmaceutical agents may also diagnose and treat
the human eye or eyes or any of its appendages for the
following conditions:
a) Infections;
b) Ocular allergies;
c) Ocular inflammation, non-surgical in cause except when
co-managed with the treating physician and surgeon;
d) Traumatic or recurrent conjunctival or corneal abrasions
and erosions;
e) Corneal surface disease and dry eyes;
f) Ocular pain, non-surgical in cause except when
co-managed with the treating physician and surgeon; and,
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g) Glaucoma in patients over the age of 18. (BPC §
3041(b)(1))
5)Permits optometrists to use the following therapeutic
pharmaceutical agents:
a) Topical miotics;
b) Topical lubricants;
c) Anti-allergy agents;
d) Topical and oral anti-inflammatories;
e) Topical antibiotic agents;
f) Topical hyperosmotics;
g) Topical and oral anti-glaucoma agents;
h) Non-prescription medications;
i) Oral antihistamines;
j) Prescription oral non-steroidal anti-inflammatory
agents;
aa) Oral antibiotics for treatment of ocular disease;
bb) Topical and oral antiviral medication for treatment of:
i) Herpes;
ii) Viral Keratitis;
iii) Herpes Simplex Viral conjunctivitis;
iv) Periocular herpes simplex viral dermatitis;
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v) Varicella zoster viral keratitis;
vi) Varicella zoster viral conjunctivitis; and,
vii) Periocular varicella zoster viral dermatitis;
cc) Oral analgesics that are not controlled substances; and,
dd) Codeine with compounds and hydrocodone with compounds
with specific restrictions regarding usage timeframe. (BPC
§ 3041(c))
6)Specifies that an optometrist who is certified to use
therapeutic pharmaceutical agents may also perform the
following:
a) Corneal scraping with cultures;
b) Debridement of corneal epithelia;
c) Mechanical epilation;
d) Venipuncture for testing patients suspected of having
diabetes;
e) Suture removal, with prior consultation with the
treating physician and surgeon;
f) Treatment or removal of sebaceous cysts by expression;
g) Administration of oral fluorescein to patients suspected
as having diabetic retinopathy;
h) Use of an auto-injector to counter anaphylaxis;
i) Ordering of smears, cultures, sensitivities, complete
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blood count, mycobacterial culture, acid fast stain,
urinalysis, tear fluid analysis and X-rays necessary for
the diagnosis of conditions or diseases of the eye or
adnexa;
j) A clinical laboratory test or examination classified as
waived under CLIA
necessary for the diagnosis of conditions and diseases of
the eye or adnexa;
aa) Punctal occlusion by plugs, excluding laser, diathermy,
cryotherapy or other means constituting surgery;
bb) The prescription of therapeutic contact lenses,
including lenses or devices that incorporate a medication
or therapy the optometrist is certified to prescribe or
provide;
cc) Removal of foreign bodies from the cornea, eyelid and
conjunctiva with any appropriate instrument other than a
scalpel or needle; and,
dd) Lacrimal irrigation and dilation, excluding probing of
the nasal lacrimal tract for patients over 12 years of age.
(BPC § 3401(e))
THIS BILL:
1)Requires the Board to establish educational and examination
requirements for licensure to ensure the competence of
optometrists to use anterior segment lasers and perform minor
procedures. Specifies that satisfactory completion of the
required educational and examination requirements shall be a
condition for the issuance of an original optometrist license
or required certifications.
2)Specifies that the Board may promulgate regulations
authorizing optometrists to use noninvasive, nonsurgical
technology to treat conditions, as specified. Further states
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that the Board shall require a licensee to take a minimum of
four hours of education courses on the new technology and
perform an appropriate number of complete clinical procedures
on live human patients to qualify to use each new technology
authorized by the Board.
3)Indicates that an optometrist who is certified to use
therapeutic pharmaceutical agents may also diagnose and treat
the human eye or eyes, or any of its or their appendages, for
all of the following conditions:
a) Through medical treatment, infections of the anterior
segment and adnexa;
b) Ocular allergies of the anterior segment and adnexa;
c) Ocular inflammation, nonsurgical in cause except when
comanaged with the treating physician and surgeon, limited
to inflammation resulting from traumatic iritis, peripheral
corneal inflammatory keratitis, episcleritis, and
unilateral nonrecurrent nongranulomatous idiopathic iritis
in patients over 18 years of age;
d) Traumatic or recurrent conjunctival or corneal abrasions
and erosions;
e) Corneal and conjunctival surface disease and dry eyes
disease;
f) Ocular pain that is nonsurgical in cause, except when
comanaged with the treating physician and surgeon; and,
g) Hypotrichosis and blepharitis;
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4)Defines "adnexa" to mean ocular adnexa.
5)Specifies that in diagnosing and treating the conditions
listed above, an optometrist certified to use therapeutic
pharmaceutical agents may use all of the following therapeutic
pharmaceutical agents:
a) Topical pharmaceutical agents for the purpose of the
examination of the human eye or eyes for any disease or
pathological condition, including, but not limited to,
topical miotics;
b) Topical lubricants;
c) Antiallergy agents. In using topical steroid medication
for the treatment of ocular allergies, an optometrist shall
consult with an ophthalmologist if the patient's condition
worsens 21 days after diagnosis;
d) Topical and oral anti-inflammatories;
e) Topical antibiotic agents;
f) Topical hyperosmotics;
g) Topical and oral antiglaucoma agents pursuant to the
certification process, as specified;
h) Nonprescription medications used for the rational
treatment of an ocular disorder;
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i) Oral antihistamines;
j) Prescription oral nonsteroidal anti-inflammatory agents;
aa)Oral antibiotics for medical treatment of ocular disease;
bb)Topical and oral antiviral medication for the medical
treatment of herpes simplex viral keratitis, herpes simplex
viral conjunctivitis, periocular herpes simplex viral
dermatitis, varicella zoster viral keratitis, varicella
zoster viral conjunctivitis, and periocular varicella
zoster viral dermatitis;
cc)Oral analgesics that are not controlled substances; and,
dd)Codeine with compounds and hydrocodone with compounds-the
use of these agents shall be limited to five days, with a
referral to an ophthalmologist if the pain persists.
6)Authorizes an optometrist who is certified to use therapeutic
pharmaceutical agents to perform all of the following:
a) Corneal scraping with cultures;
b) Debridement of corneal epithelia;
c) Mechanical epilation;
d) Collection of blood by skin puncture or venipuncture for
testing patients suspected of having diabetes;
e) Suture removal, with prior consultation with the
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treating health care provider;
f) Treatment or removal of sebaceous cysts by expression;
g) Administration of oral fluorescein to patients suspected
as having diabetic retinopathy;
h) Use of an auto-injector to counter anaphylaxis;
i) Ordering of smears, cultures, sensitivities, complete
blood count, mycobacterial culture, acid fast stain,
urinalysis, tear fluid analysis, and X-rays necessary for
the diagnosis of conditions or diseases of the eye or
adnexa. An optometrist may order other types of images
subject to prior consultation with an ophthalmologist or
appropriate physician and surgeon;
j) A clinical laboratory test or examination classified as
waived under the Clinical Laboratory Improvement Amendments
of 1988 (CLIA) (42 U.S.C. Sec. 263a; Public Law 100-578)
necessary for the diagnosis of conditions and diseases of
the eye or adnexa, to detect systemic disease with ocular
effects;
aa)Skin test to diagnose ocular allergies. Skin tests shall
be limited to the superficial layer of the skin;
bb)Punctal occlusion by plugs, excluding laser, diathermy,
cryotherapy, or other means constituting surgery as
specified;
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cc)The prescription of therapeutic contact lenses, diagnostic
contact lenses, or biological or technological corneal
devices that diagnose or treat a condition, as specified;
dd)Removal of foreign bodies from the cornea, eyelid, and
conjunctiva with any appropriate instrument other than a
scalpel. Corneal foreign bodies shall be nonperforating, be
no deeper than the midstroma, and require no surgical
repair upon removal;
ee)For patients over 12 years of age, lacrimal irrigation and
dilation, excluding probing of the nasal lacrimal tract;
i) The Board shall certify any optometrist who
graduated from an accredited school of optometry before
May 1, 2000, to perform this procedure after submitting
proof of satisfactory completion and confirmation of 10
procedures under the supervision of an ophthalmologist or
optometrist who is certified in lacrimal irrigation and
dilation. Any optometrist who graduated from an
accredited school of optometry on or after May 1, 2000,
shall be exempt from the certification requirement.
ff)Use of mechanical lipid extraction of meibomian glands and
nonsurgical techniques.
7) Specifies that In order to be certified to use therapeutic
pharmaceutical agents and authorized to diagnose and treat the
conditions listed above, an optometrist shall apply for a
certificate from the Board and meet all requirements imposed
by the Board.
8)Authorizes the Board to grant a certificate to use therapeutic
pharmaceutical agents to any applicant who graduated from a
California accredited school of optometry prior to January 1,
1996, is licensed as an optometrist in California, and meets
specified education and training requirements
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9) Authorizes the Board to grant a certificate to use
therapeutic pharmaceutical agents 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 training and education
requirements:
10) Indicates that other than for prescription ophthalmic
devices as specified, any dispensing of a therapeutic
pharmaceutical agent by an optometrist shall be without
charge.
11) Specifies that the practice of optometry does not include
performing surgery. "Surgery" means any procedure in which
human tissue is cut, altered, or otherwise infiltrated by
mechanical or laser means, as specified.
12)Specifies an optometrist's authority to utilize diagnostic
laser and ultrasound technology within his or her scope of
practice.
13)States that in an emergency, an optometrist shall stabilize,
if possible, and immediately refer any patient who has an
acute attack of angle closure to an ophthalmologist.
14)Defines "glaucoma" as:
a) All primary open-angle glaucoma;
b) Exfoliation and pigmentary glaucoma;
c) Increase in intraocular pressure caused by steroid
medication prescribed by the optometrist; and,
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d) Increase in intraocular pressure caused by steroid
medication not prescribed by the optometrist, after
consultation and treatment approval by the prescribing
physician.
15)Specifies requirements for optometrists certified for the
treatment of glaucoma, in patients over 18 years of age.
16)Defines "anterior segment laser" as any of the following:
a) Therapeutic lasers appropriate for treatment of
glaucoma;
b) Peripheral iridotomy for the prophylactic treatment of
angle closure glaucoma; and,
c) Therapeutic lasers used for posterior capsulotomy
secondary to cataract surgery.
17) States that an optometrist certified to treat glaucoma shall
be additionally certified for the use of anterior segment
lasers after submitting proof of satisfactory completion of a
course that is approved by the Board, provided by an
accredited school of optometry, and developed in consultation
with an ophthalmologist who has experience educating
optometric students. The Board shall issue a certificate only
to an optometrist that has graduated from an approved school
of optometry.
18)Indicates that the Board-approved course shall be at least 25
hours in length, and include a test for competency of the
following:
a) Laser physics, hazards, and safety;
b) Biophysics of laser;
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c) Laser application in clinical optometry;
d) Laser tissue interactions;
e) Laser indications, contraindications, and potential
complications;
f) Gonioscopy;
g) Laser therapy for open-angle glaucoma;
h) Laser therapy for angle closure glaucoma;
i) Posterior capsulotomy;
j) Common complications of the lids, lashes, and lacrimal
system;
aa)Medicolegal aspects of anterior segment procedures;
bb)Peripheral iridotomy; and,
cc)Laser trabeculoplasty.
19)States that the school of optometry shall require each
applicant for certification to perform a sufficient number of
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complete anterior segment laser procedures to verify that the
applicant has demonstrated competency to practice
independently. At a minimum, each applicant shall complete 24
anterior segment laser procedures on live humans as follows:
a) Eight YAG capsulotomy procedures;
b) Eight laser trabeculoplasty procedures; and,
c) Eight peripheral iridotomy procedures.
20)Requires the Board, by regulation, to set the fee for
issuance and renewal of a certificate authorizing the use of
anterior segment lasers at an amount no higher than the
reasonable cost of regulating anterior segment laser certified
optometrists, as specified. The fee shall not exceed one
hundred fifty dollars ($150).
21)Requires an optometrist certified to use anterior segment
lasers to complete four hours of continuing education on
anterior segment lasers as part of the required 50 hours of
continuing education required to be completed every two years
on the diagnosis, treatment, and management of glaucoma.
22) Defines "minor procedure" as any of the following:
a) Removal, destruction, or drainage of lesions of the
eyelid and adnexa clinically evaluated by the optometrist
to be noncancerous, not involving the eyelid margin,
lacrimal supply or drainage systems, no deeper than the
orbicularis muscle, and smaller than five millimeters in
diameter;
b) Closure of a wound resulting from a procedure, as
specified; or,
c) Administration of injections for the diagnoses or
treatment of conditions of the eye and adnexa authorized by
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this chapter, excluding intraorbital injections and
injections administered for cosmetic effect.
23)Specifies that "minor procedures" do not include
blepharoplasty or other cosmetic surgery procedures that
reshape normal structures of the body in order to improve
appearance and self-esteem.
24)Indicates that an optometrist certified to treat glaucoma
shall be additionally certified to perform minor procedures
after submitting proof of satisfactory completion of a course
that is approved by the Board, provided by an accredited
school of optometry, and developed in consultation with an
ophthalmologist who has experience teaching optometric
students. The Board shall issue a certificate pursuant to this
section only to an optometrist that has graduated from an
approved school of optometry.
25)Requires that the Board-approved course be at least 25 hours
in length and include a test for competency of the following:
a) Minor surgical procedures;
b) Overview of surgical instruments, asepsis, and the state
and federal Occupational Safety and Health Administrations;
c) Surgical anatomy of the eyelids;
d) Emergency surgical procedures;
e) Chalazion management;
f) Epiluminescence microscopy;
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g) Suture techniques;
h) Local anesthesia techniques and complications;
i) Anaphylaxsis and other office emergencies;
j) Radiofrequency surgery;
aa)Postoperative wound care; and,
bb)Injection techniques.
26)Requires the school of optometry to require each applicant
for certification to perform a sufficient number of minor
procedures to verify that the applicant has demonstrated
competency to practice independently. At a minimum, each
applicant shall perform 32 complete minor procedures on live
humans.
27)Authorizes the Board, by regulation, to set the fee for
issuance and renewal of a certificate authorizing the use of
minor procedures at an amount no greater than the reasonable
cost of regulating minor procedure certified optometrists
pursuant to this section. The fee shall not exceed one hundred
fifty dollars ($150).
28)Requires an optometrist certified to perform minor procedures
to complete five hours of continuing education on the
diagnosis, treatment, and management of lesions of the eyelid
and adnexa as part of the 50 hours of continuing education
required every two years.
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29) Authorizes the Board to grant to an optometrist a
certificate for the use of immunizations, if the optometrist
is certified and has met all of the following requirements:
a) Completes an immunization training program endorsed by
the federal Centers for Disease Control and Prevention
(CDC) that, at a minimum, includes hands-on injection
technique, clinical evaluation of indications and
contraindications of vaccines, and the recognition and
treatment of emergency reactions to vaccines, and maintains
that training;
b) Is certified in basic life support; and,
c) Complies with all state and federal recordkeeping and
reporting requirements, including providing documentation
to the patient's primary care provider and entering
information in the appropriate immunization registry
designated by the immunization branch of the State
Department of Public Health.
30)Defines "immunization" as the administration of immunizations
for influenza, herpes zoster virus, and pneumococcus in
compliance with individual Advisory Committee on Immunization
Practices (ACIP) vaccine recommendations published by the CDC
for persons 18 years of age or older.
31)Authorizes the Board, by regulation, to set the fee for
issuance and renewal of a certificate for the use of
immunizations at the reasonable cost of regulating
immunization certified optometrists. The fee shall not exceed
one hundred dollars ($100).
32) Subjects optometrists to laws regarding the purposes of
practicing telehealth.
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33)Indicates that optometrists diagnosing or treating eye
disease shall be held to the same standard of care to which
physicians and surgeons and osteopathic physicians and
surgeons are held. An optometrist shall consult with and, if
necessary, refer to a physician and surgeon or other
appropriate health care provider when a situation or condition
occurs that is beyond the optometrist's scope of practice.
34) Declares that it is the intent of the Legislature that the
Office of Statewide Health Planning and Development, under the
Health Workforce Pilot Projects Program, designate a pilot
project to test, demonstrate, and evaluate expanded roles for
optometrists in the performance of management and treatment of
diabetes mellitus, hypertension, and hypercholesterolemia.
FISCAL EFFECT: Unknown. This bill has been keyed fiscal by the
Legislative Counsel.
COMMENTS:
Purpose. This bill is sponsored by the author. According to
the author, "While merely 16 of California's 58 counties meet
the needed supply range for primary care physicians, we do have
a robust network of providers that are well-trained, evenly
distributed throughout the state, regulated by the [DCA] and
well positioned to pay particular attention to currently
underserved areas. Optometrists are one such provider group who
receive a doctorate level training preparing them to be primary
eye care providers, and independently diagnose and treat
conditions of the eye. [This bill] will remove restrictions in
current law to permit optometrists to examine, prevent,
diagnose, and treat conditions and disorders of the visual
system and the human eye to the full extent of their training.
This includes the use of two types of therapeutic lasers by
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optometrists with postdoctoral advanced certification that have
been developed for treatment of glaucoma and post-surgical
cataract care, conditions that disproportionately affect patient
groups that generally lack sufficient access to physicians.
[This bill] is a limited expansion of scope for optometrists
that is consistent with their education and training, and is a
logical advancement of the profession that has been proven safe
in other states. Moreover, the educational requirements
contained in this bill are substantially greater than those
required of optometrists in other states and exceed the minimum
number of these procedures required for ophthalmologists by the
Accreditation Council for Graduate Medical Education."
Background. According to a report prepared by the Center for
the Health Professions at the University of California San
Francisco, the number of optometrist licenses in California has
declined, but the number of licensees with a secondary practice
location has increased. According to the Board, there are over
7,000 licensed optometrists in California, the largest
population of optometrists in the United States. The majority
of the licensed optometrists are generally concentrated in
coastal counties, the Bay Area and counties in the Sacramento
region. Several counties have no licensed optometrists with an
address of record in those counties, and a number of other
counties have ratios that indicate there is approximately one
optometrist for every 10,000 people.
Optometrists' and Ophthalmologists' Education, Training, and
Scope. This bill would expand the types of procedures an
optometrist is authorized to perform. This would include some
tasks that have been traditionally performed by
ophthalmologists. As such, the current education, training and
scope of each profession is outlined below.
Optometrists. Optometrists are trained to diagnose mild
to severe eye problems such as serious eye infections,
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inflammations of the eye, trauma, foreign bodies and
glaucoma. They also examine the eye for vision
prescription and corrective lenses.
After completion of an undergraduate degree, optometrists
complete four years of and accredited optometry college
after which they are awarded the Doctor of Optometry
degree. Some optometrists also undertake an optional one
year non-surgical residency program to enhance their
experience in a particular area. Students graduate with
2500 to 3000 patient encounters; these include a mix of
post-surgical, medical and routine visits.
Optometrists who graduated from an accredited school or
college of optometry on or after May 1, 2008 receive
certifications to use diagnostic pharmaceutical agents
(DPA); to administer therapeutic pharmaceutical agents
(TPA); to perform lacrimal irrigation and dilation (TPL);
and to diagnose and treat primary open angle glaucoma
(TLG). Optometrists who did not receive these
certifications upon licensure may apply for these
certifications after meeting the necessary requirements. In
order to be certified, the optometrist must pass an exam,
obtain a license to practice optometry, be certified by and
accredited school of optometry that they are competent in
the diagnosis, treatment and management of ocular systemic
disease, and complete 10 hours of supervised practice with
an ophthalmologist.
Ophthalmologists. The central focus of ophthalmology is
surgery and management of complex eye diseases. An
ophthalmologist specializes in the refractive, medical and
surgical care of the eyes and visual system and in the
prevention of disease and injury.
After obtaining an undergraduate degree, ophthalmologists
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complete four years at an accredited medical school and earn a
Medical Degree. This is followed by a one year internship and a
three or four year surgical residency. Many ophthalmologists
pursue additional fellowship training in specialized areas such
as retina, glaucoma, or cornea. Ophthalmologists may become
certified by the American Board of Ophthalmology, which
requires, serving as the primary surgeon or first assistant to
the primary surgeon for a minimum of 364 eye surgeries.
Other States. Since 1997, there have been over 45 attempts in
over 20 states by optometry associations to expand the scope of
practice for optometrists including legislating surgery
privileges. However, with the exception of Oklahoma and West
Virginia, most states continue to prohibit optometrists from
performing surgery, and their statutes specify that the license
to practice optometry does not include the right to practice
medicine. States such as Colorado and North Carolina
specifically exclude surgery from their definition of the
practice of optometry. Other states have statutes that
delineate between laser and non-laser surgery. Optometrists are
authorized to prescribe oral medications in all 50 states, they
may prescribe oral steroids in 34 states, injections in 15
states and use lasers in 1 state.
Prior Related Legislation. SB 492 (Hernandez) of 2013, would
have permitted an optometrist to diagnose treat and manage
additional conditions with ocular manifestations, directed the
Board to establish educational and examination requirements and
would have permitted optometrists to perform vaccinations and
surgical and non-surgical primary care procedures. NOTE: This
bill died on the Assembly inactive file.
SB 668 (Polanco) Chapter 13, Statutes of 1996, expanded the
scope of practice of optometrists to provide for the diagnosis
and treatment of specified conditions or diseases of the human
eye or its appendages, and to use other therapeutic
pharmaceutical agents.
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SB 929 (Polanco) Chapter 676, Statutes of 2000, expanded the
scope of lawful practice for optometrists by specifying
additional diseases and conditions that optometrists may treat
(in particular certain types of glaucoma) with specified
medications, and by specifying the extent of physician
involvement that is required under various circumstances.
SB 1406 (Correa) Chapter 352, Statutes of 2008, specified
permissible procedures for certified optometrists, and created
the Glaucoma Diagnosis and Treatment Advisory Committee to
establish glaucoma certification requirements.
AMENDMENTS:
1)The author outlines the need for additional health care
practitioners to be permitted to administer vaccines to
patients. As such, the author should strike all contents of
the bill, with the exception of the provisions authorizing an
optometrist to, after completing training as specified in the
bill, be certified by the Board to provide the following
vaccinations: 1) influenza, 2) herpes zoster virus, and 3)
pneumococcus for persons 18 years of age or older.
2)The current bill specifies the number of hours of training
that an optometrist must complete in order to enjoy an
expanded scope of practice. As there has been much debate
about training, education, competence, and appropriateness of
expanding the scope of practice for optometrists, the author
should instead amend the bill to create a task force under the
Board, including those most qualified to review the education
and training of optometrists, and determine the hours of
training and education needed to perform the following
procedures: 1) YAG capsulotomy procedures, 2) laser
trabeculoplasty procedures, and 3) peripheral iridotomy
procedures.
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The members of the task force should be appointed by the
Director of the Department of Consumer Affairs by May 1, 2017.
The task force should include: one professor of optometry,
one practicing optometrist, one professor of ophthalmology,
one practicing ophthalmologist, and one member of the public
who has never been licensed by, or appointed to, the Board or
the Medical Board of California.
The taskforce shall submit a report with recommendations on
what the expanded scope for optometrists should include, as it
pertains to the three specified procedures above, to the
Governor, the President pro Tempore of the Senate, the Speaker
of the Assembly, the Assembly Committee on Business and
Professions, and the Senate Committee on Business, Professions
and Economic Development, by May 1, 2018, on which date the
task force shall cease to exist.
REGISTERED SUPPORT:
California Optometric Association
747 individuals
REGISTERED OPPOSITION:
American Academy of Dermatology Association
American Academy of Ophthalmology
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American Association for Pediatric Ophthalmology and Strabismus
American College of Surgeons
American Glaucoma Society
American Medical Association
American Society of Cataract and Refractive Surgery
American Society of Ophthalmic Plastic and Reconstructive
Surgery
American Society of Retina Specialists
Blind Children's Center
California Academy of Eye Physicians and Surgeons (unless
amended)
California Academy of Family Physicians
California Black Chamber of Commerce
California Black Health Network
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California Medical Association
California Society of Plastic Surgeons, Inc.
Capitol City Church
CB Communications
Faith in Action
Health & Human Resource Education Center
Inner Beauty
International Black Health Alliance
Let's Face it Together
Lighthouse for Christ Mission
Medical Board of California (unless amended)
Sacramento Black Chamber of Commerce
Sacramento Cultural Hub
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San Diego Black Health Associates
Stanford University School of Medicine
The Green Foundation
Over 400 individuals
Analysis Prepared by:Le Ondra Clark Harvey, Ph.D. / B. & P. /
(916) 319-3301