BILL ANALYSIS
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|SENATE RULES COMMITTEE | AB 2683|
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THIRD READING
Bill No: AB 2683
Author: Hernandez (D)
Amended: 7/15/10 in Senate
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE : 7-0,
6/28/10
AYES: Negrete McLeod, Aanestad, Calderon, Corbett, Correa,
Florez, Yee
NO VOTE RECORDED: Wyland, Walters
SENATE APPROPRIATIONS COMMITTEE : Senate Rule 28.8
ASSEMBLY FLOOR : 72-0, 5/20/10 (Consent) - See last page
for vote
SUBJECT : Optometry
SOURCE : Board of Optometry
DIGEST : This bill authorizes optometrists to practice in
long-term care settings such as skilled nursing facilities
(nursing homes), psychiatric hospitals, and intermediate
care facilities.
ANALYSIS :
Existing law:
1. Licenses and regulates the practice of optometry by the
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Board of Optometry (Board) within the Department of
Consumer Affairs (DCA).
2. Requires an optometrist to notify the Board in writing
of the address or addresses where he or she is to
engage, or intends to engage, in the practice of
optometry.
3. Exempts an optometrist from notifying the Board if he or
she engages in temporary practice which is limited to
seven calendar days during a 30-day period and 54 days
during the calendar year at any the following settings:
A facility licensed by the Department of Public
Health.
A public institution, including, but not limited
to, a school, community college, or correctional
facility.
A mobile unit operated by a governmental agency
or nonprofit or charitable organization.
The home of a non-ambulatory patient.
The practice location of a licensed optometrist
who is absent for a reason approved by the Board.
4. Authorizes an assistant in the office of a physician and
surgeon or optometrist under the direct responsibility
and supervision of a physician and surgeon or
optometrist to fit prescription lenses.
5. Specifies additional duties that an assistant may
perform in the office of, and under the direct
supervision of, an ophthalmologist or optometrist.
This bill:
1. Authorizes an optometrist to engage in the practice of
optometry at any health facility or residential care
facility, provided the optometrist:
A. Maintains a primary business office, separate from
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the health facility or residential care facility,
that meets all of the following requirements:
Is open to the public during normal
business hours by telephone and for purposes of
billing services or access to patient records.
Is licensed to the optometrist or the
employer of the optometrist as a local business
with the city or county in which it is located.
Is registered by the optometrist with the
Board.
Is owned or leased by the optometrist or by
the employer of the optometrist.
Is not located in or connected with a
residential dwelling.
B. Maintains or discloses patient records in the following
manner:
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. The disclosure of records shall be made
at or near the time services are rendered and shall
be maintained at the primary business office.
The optometrist 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 (HIPA) Act of 1996.
The optometrist keeps all necessary records for a
minimum of seven years from the date of service. Any
information shall be certified by the optometrist as
being true, accurate, and complete.
Records shall be maintained for each prescription
as part of the patient's chart, including the
optometrist's name and license number, the place of
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practice or primary business office, and the
description of the goods and services for which the
patient is charged and the amount charged.
A copy of any referral or order requesting
optometric services for a patient from the health
facility's or residential care facility's
administrator, director of social services, the
attending physician and surgeon, the patient, or a
family member shall be kept in the patient's medical
record.
C. Possesses and appropriately uses the instruments
and equipment required for all optometric services
and procedures performed within the health facility
or residential care facility.
2. Exempts an optometrist from providing notification to
the Board of each health facility or residential care
facility, provided all requirements are met.
3. Defines certain terms for purposes of the above
provisions, including:
A. Health facility as specified in the Health and
Safety Code, exclusive of a hospital, as defined.
B. Residential care facility as a residential
facility licensed by the Department of Social
Services.
4. Authorizes an assistant to fit prescription lenses and
perform those additional duties in any setting where
optometry or ophthalmology is practiced, under the
direct responsibility and supervision of a physician and
surgeon, optometrist, or ophthalmologist, respectively.
5. Defines "setting" for purposes of # 4 above, to include,
but not be limited to, any facility licensed by the
Department of Public Health or the Department of Social
Services.
6. Makes technical, clarifying and conforming changes.
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Background
Optometrists diagnose and treat vision problems and eye
diseases and write prescriptions for eyeglasses, contact
lenses, and medications. Optometrists are required to
complete at least three years of study at an accredited
college or university before beginning specialized
optometry training. The specialized training is four years
in duration and the optometry student must then pass
written and clinical state board examinations prior to
licensure. Currently, more than 6,500 optometrists
practice in California.
In 2007, AB 986 (Eng) authorized optometrists to practice
at temporary locations in a similar fashion to statutes
that authorize dentists to work at temporary practice
locations, such as nursing homes, schools, and other public
institutions. However, those provisions only authorized a
limited term timeframe for the practice of optometry at
these temporary locations; seven calendar days during a
30-day period and 54 days during the calendar year.
Prior Legislation
AB 986 (Eng), Chapter 276, Statutes of 2007, allowed the
practice of optometry at temporary locations under certain
conditions, established a retention period for optometrists
to maintain patient records, and increased licensing fees.
SB 929 (Polanco), Chapter 676, Statutes of 2000, among
other things, authorized assistants working in the office
of an optometrist or ophthalmologist, and under the direct
supervision of an optometrist or ophthalmologist, to
perform a number of optometric tests and procedures.
FISCAL EFFECT : Appropriation: No Fiscal Com.: Yes
Local: Yes
SUPPORT : (Verified 8/4/10)
Board of Optometry (source)
Advanced Eyecare, Inc.
Chairman, UC Davis Eye Center
Vision Service Plan
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ARGUMENTS IN SUPPORT : According to the author:
"California laws are vague and do not adequately address
notification, standard of practice and record keeping
requirements for optometrists who practice in health
facilities. A definition of optometric care in
non-traditional settings is needed in order to allow
optometrists to provide this type of care in a way that
will protect the public and increase access to care.
Furthermore, due to low overhead costs and potentially
high profit margins, increasing numbers of optometrists
are providing this type of care either part-time or as a
sole mode of practice.
"Additionally, over the next several years and decades,
Californian's and the nations' baby boom generation are
reaching age 65 and represent among the fastest growing
population in the state and in the nation. It is
projected that the number of elderly patients who live in
assisted living facilities, traditional nursing homes,
and various tiers of intermediate care is expected to
double by year 2030. The concomitant expectation is that
a great number of professional services, such as
optometric services will be rendered for a
non-ambulatory, or relatively immobile, percentage of the
population. The Board wants to ensure that optometric
services rendered to patients in these settings are
provided in a manner as consistent as possible with the
level of care that would be provided by the practitioner
in his/her regular practice location."
ASSEMBLY FLOOR :
AYES: Adams, Ammiano, Anderson, Arambula, Bass, Beall,
Bill Berryhill, Tom Berryhill, Blakeslee, Block,
Blumenfield, Bradford, Brownley, Buchanan, Caballero,
Charles Calderon, Carter, Chesbro, Conway, Cook, Coto,
Davis, De Leon, DeVore, Emmerson, Eng, Feuer, Fong,
Fuentes, Fuller, Furutani, Gaines, Galgiani, Garrick,
Gilmore, Hagman, Hall, Hayashi, Hernandez, Hill, Huber,
Huffman, Jeffries, Jones, Knight, Lieu, Logue, Bonnie
Lowenthal, Ma, Mendoza, Miller, Monning, Nestande,
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Niello, Nielsen, Norby, V. Manuel Perez, Portantino,
Ruskin, Salas, Saldana, Silva, Skinner, Smyth, Solorio,
Audra Strickland, Swanson, Torlakson, Torres, Torrico,
Tran, Yamada
NO VOTE RECORDED: De La Torre, Evans, Fletcher, Harkey,
Nava, Villines, John A. Perez, Vacancy
JJA:mw 8/4/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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