BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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          |SENATE RULES COMMITTEE            |                   AB 175|
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                                 THIRD READING


          Bill No:  AB 175
          Author:   Galgiani (D), et al
          Amended:  6/24/09 in Senate
          Vote:     21

           
           SEN. BUS., PROF. & ECON. DEV. COMMITTEE  :  10-0, 6/29/09
          AYES:  Negrete McLeod, Wyland, Aanestad, Corbett, Correa,  
            Florez, Oropeza, Romero, Walters, Yee

           SENATE HEALTH COMMITTEE  :  10-0, 6/17/09
          AYES:  Alquist, Strickland, Aanestad, Cedillo, Cox,  
            DeSaulnier, Leno, Maldonado, Pavley, Wolk
          NO VOTE RECORDED:  Negrete McLeod

           SENATE APPROPRIATIONS COMMITTEE  :  13-0, 8/27/09
          AYES:  Kehoe, Cox, Corbett, Denham, Hancock, Leno, Oropeza,  
            Price, Runner, Walters, Wolk, Wyland, Yee

           ASSEMBLY FLOOR  :  77-0, 05/21/09 - See last page for vote


           SUBJECT  :    Medical telemedicine:  optometrists

           SOURCE  :     Department of Health Care Services


           DIGEST  :    This bill expands the definition of  
          teleophthalmology and teledermatology by store and forward  
          to include the services of an optometrist.

           ANALYSIS  :    

                                                           CONTINUED





                                                                AB 175
                                                                Page  
          2

           Existing Law

           1.Establishes the Medi-Cal program, administered by the  
            Department of Health Care Services (DHCS), which provides  
            comprehensive health benefits to low-income children;  
            their parents or caretaker relatives; pregnant women;  
            elderly, blind or disabled persons; nursing home  
            residents; and refugees who meet specified eligibility  
            criteria.

          2.Establishes the Telemedicine Development Act of 1996,  
            which broadly defines telemedicine as the use of  
            information technology to deliver medical services and  
            information from one location to another, and imposes  
            several requirements governing the delivery of health  
            care services through telemedicine.

          3.Defines, in the Medical Practice Act, telemedicine as the  
            practice of health care delivery, diagnosis,  
            consultation, treatment, transfer of medical data, and  
            education using interactive audio, video or data  
            communications.

          4.Allows the use of telemedicine in the Medi-Cal program,  
            when those services would be otherwise covered by the  
            program when appropriate, and when the contact between  
            the health care provider and the patient is real time or  
            near real time.

          5.Defines, for the purposes of Medi-Cal, "teleophthalmology  
            and teledermatology by store and forward" as transmission  
            of medical information to be reviewed at a later time and  
            at a distant site by a physician who is trained in  
            ophthalmology or dermatology, where the physician at the  
            distant site reviews the medical information without the  
            patient being present in real time and allows these  
            telemedicine services to be reimbursed under the Medi-Cal  
            program.

          6.Provides a sunset date of January 1, 2013 for these  
            provisions.

          7.Authorizes optometrists to engage in the practice of  
            telemedicine in California.







                                                                AB 175
                                                                Page  
          3


          This bill:

          1.Expands the definition of teleophthalmology and  
            teledermatology by store and forward to include the  
            services of an optometrist.

          2.Requires that if the reviewing optometrist identifies a  
            disease or condition requiring consultation or referral,  
            as specified, that consultation shall be with an  
            ophthalmologist or other appropriate physician and  
            surgeon.  

          Background

           The 1996 Telemedicine Development Act declared the lack of  
          primary care and specialty providers, combined with  
          inadequate transportation are significant barriers to  
          access to health services in medically underserved rural  
          and urban areas.  The Act also declares that parts of  
          California have difficulty attracting and retaining health  
          professionals, as well as supporting health facilities to  
          provide a continuum of health care.

          Telemedicine is increasingly being seen as part of the  
          approach to address the problem of inadequate access to  
          providers, especially specialists, and the development of  
          health systems in medically underserved areas.   
          Telemedicine can improve communication capabilities and  
          provide convenient access to up-to-date information,  
          consultation and other forms of support.  Telemedicine can  
          result in consumers benefiting from expanded access to  
          providers, faster and more convenient treatment, better  
          continuity of care, reduction of lost work time and travel  
          costs, and the ability to receive care while they remain  
          with support networks.  In traditional telemedicine, a  
          physician at a distant site is able to interview and  
          examine the patient via closed circuit television.  Store  
          and forward telemedicine allows video recording with  
          viewing of the recording at a later time by a health care  
          provider at a distant location.  Store and forward is  
          especially applicable to the fields of dermatology and  
          ophthalmology where visual examination is important in  
          diagnosis.







                                                                AB 175
                                                                Page  
          4


          According to the National Eye Institute, diabetic  
          retinopathy, which is damage to the blood vessels at the  
          back of the eye, is a leading cause of blindness in  
          American adults.  The California HealthCare Foundation  
          (CHCF), in a March 2009 report on its diabetic retinopathy  
          program, states 24,000 diabetics become legally blind each  
          year in the United States, but clinical trials demonstrate  
          that early detection and treatment can prevent 90 percent  
          of vision loss.  The National Eye Institute recommends that  
          everyone with diabetes - whether type I or type II - get an  
          annual comprehensive dilated eye exam.

          According to CHCF, residents of California's Central Valley  
          face the challenges of high rates of diabetes, high rates  
          of poverty, low insurance rates, lack of regular sources of  
          care, health provider shortages, and a rural setting that  
          poses transportation obstacles.  CHCF funded a pilot  
          project to implement screening for diabetic retinopathy  
          using EyePACS which is open-source telemedicine software  
          that the University of California, Berkeley School of  
          Optometry developed specifically for exchanging eye-related  
          clinical information.  Providers in the 13 primary care  
          sites in the pilot project screened over 12,000 patients,  
          of whom 15 percent required referrals for further eye care.  
           CHCF subsequently expanded the project to help 43 more  
          clinics throughout the state to acquire digital retinal  
          cameras, telemedicine software and/or expert consultation.   
          CHCF's goal for this program is 100 clinics and 100,000  
          patients.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes    
          Local:  No

                          Fiscal Impact (in thousands)

           Major Provisions             2009-10            2010-11          
              2011-12           Fund  

          Increased retinal          $33 - $102       $75 - $237       
           $86 - $270     General/*
          scan reimbursement    $53 - $167       $96 - $302       $86  
          - $270      Federal








                                                                AB 175
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          *October 1, 2008 - December 31, 2010 FMAP = 38% GF/62% FF
            January 1, 2011 - ongoing FMAP - 50% GF/ 50% FF
            FMAP = Federal Medical Assistance Percentage - the  
          percent of total costs
            paid by the federal government

           SUPPORT  :   (Verified  8/27/09)

          Department of Health Care Services (source)
          American Federation of State, County and Municipal  
          Employees, AFL-CIO
          California Optometric Association
          California Primary Care Association
          Medical Board of California

           ARGUMENTS IN SUPPORT  :    DHCS, the sponsor of the bill,  
          argues that this bill enables the Medi-Cal program to  
          recognize optometrists as an additional provider for  
          telephthalmology services store and forward technology.   
          They noted that optometrists are already authorized to use  
          telemedicine but are restricted from providing these  
          services to Medi-Cal patients.  The California Optometric  
          Association states that passage of this bill will assure  
          that more patients at risk of becoming blind from diabetes  
          or glaucoma will be diagnosed and treated sooner.  They  
          point out that optometrists are now the first line of  
          defense against debilitating eye disease; data show that  
          seven out of ten eye care patients visit an optometrist  
          first, where threats to visual health and eyesight are  
          first diagnosed.


           ASSEMBLY FLOOR  : 
          AYES: Adams, Ammiano, Anderson, Arambula, Beall, Bill  
            Berryhill, Tom Berryhill, Blakeslee, Block, Blumenfield,  
            Brownley, Buchanan, Caballero, Charles Calderon, Carter,  
            Chesbro, Conway, Cook, Coto, Davis, De La Torre, DeVore,  
            Duvall, Emmerson, Eng, Evans, Feuer, Fletcher, Fong,  
            Fuentes, Fuller, Furutani, Gaines, Galgiani, Garrick,  
            Gilmore, Hagman, Hall, Harkey, Hayashi, Hernandez, Hill,  
            Huber, Huffman, Jeffries, Jones, Knight, Krekorian, Lieu,  
            Logue, Bonnie Lowenthal, Ma, Mendoza, Miller, Monning,  
            Nava, Nestande, Niello, Nielsen, John A. Perez, V. Manuel  
            Perez, Portantino, Ruskin, Salas, Silva, Skinner, Smyth,  







                                                               AB 175
                                                                Page  
          6

            Solorio, Audra Strickland, Swanson, Torlakson, Torres,  
            Torrico, Tran, Villines, Yamada, Bass
          NO VOTE RECORDED: De Leon, Price, Saldana


          CTW:JJA:cm  8/28/09   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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