SB 762: Optometry: administration of immunizations.
- Session Year: 2017-2018
- House: Senate
- Latest Version Date: 2018-09-10
The Optometry Practice Act provides for the licensure and regulation of the practice of optometry by the State Board of Optometry in the Department of Consumer Affairs. The act requires an optometrist who has been certified to use therapeutic pharmaceutical agents to be certified for the administration of immunizations by complying with specified requirements, including completing an immunization training program endorsed by the federal Centers for Disease Control and Prevention.
This bill would instead require the training program to be endorsed by the federal Centers for Disease Control and Prevention or the Accreditation Council for Pharmacy Education. The bill would also make nonsubstantive changes, including correcting erroneous cross-references.
This bill would declare that it is to take effect immediately as an urgency statute.
The Optometry Practice Act provides for the licensure and regulation of the practice of optometry by the State Board of Optometry in the Department of Consumer Affairs. The act requires an optometrist who has been certified to use therapeutic pharmaceutical agents to be certified for the administration of immunizations by complying with specified requirements, including completing an immunization training program endorsed by the federal Centers for Disease Control and Prevention.
This bill would instead require the training program to be endorsed by the federal Centers for Disease Control and Prevention or the Accreditation Council for Pharmacy Education. The bill would also make nonsubstantive changes, including correcting erroneous cross-references.
This bill would declare that it is to take effect immediately as an urgency statute.
The Optometry Practice Act provides for the licensure and regulation of the practice of optometry by the State Board of Optometry in the Department of Consumer Affairs. The act requires an optometrist who has been certified to use therapeutical pharmaceutical agents to be certified for the administration of immunizations by complying with specified requirements, including completing an immunization training program endorsed by the federal Centers for Disease Control and Prevention.
This bill would instead require the training program to be endorsed by the federal Centers for Disease Control and Prevention or the Accreditation Council for Pharmacy Education. The bill would also make nonsubstantive changes, including correcting erroneous cross-references.
This bill would declare that it is to take effect immediately as an urgency statute.
The Optometry Practice Act provides for the licensure and regulation of the practice of optometry by the State Board of Optometry in the Department of Consumer Affairs. The act requires an optometrist who has been certified to use therapeutical pharmaceutical agents to be certified for the administration of immunizations by complying with specified requirements, including completing an immunization training program endorsed by the federal Centers for Disease Control and Prevention.
This bill would instead require the training program to be endorsed by the federal Centers for Disease Control and Prevention or the Accreditation Council for Pharmacy Education. The bill would also make nonsubstantive changes, including correcting erroneous cross-references.
Existing law requires a healing arts board, as defined, to issue, upon application and payment of the normal renewal fee, an inactive license or certificate to a current holder of an active license or certificate whose license or certificate is not suspended, revoked, or otherwise punitively restricted by the board. Existing law requires the holder of an inactive license or certificate to, among other things, pay the renewal fee in order to restore his or her license or certificate to an active status. Existing law requires the renewal fee to be waived for a physician and surgeon who certifies to the Medical Board of California that license restoration is for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation that provides medical services to indigent patients in medically underserved or critical-need population areas of the state.This bill would require the renewal fee to be waived for any healing arts licensee who certifies to his or her respective board that license restoration is for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation that provides medical services to indigent patients in medically underserved or critical-need population areas of the state.Existing law requires a healing arts board, as defined, to issue, upon application and payment of the normal renewal fee, an inactive license or certificate to a current holder of an active license or certificate whose license or certificate is not suspended, revoked, or otherwise punitively restricted by the board. Existing law requires the holder of an inactive license or certificate to, among other things, pay the renewal fee in order to restore his or her license or certificate to an active status. Existing law requires the renewal fee to be waived for a physician and surgeon who certifies to the Medical Board of California that license restoration is for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation that provides medical services to indigent patients in medically underserved or critical-need population areas of the state.
This bill would require the renewal fee to be waived for any healing arts licensee who certifies to his or her respective board that license restoration is for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation that provides medical services to indigent patients in medically underserved or critical-need population areas of the state.
The federal Workforce Innovation and Opportunity Act of 2014 provides for workforce investment activities, including activities in which states may participate. Existing law contains various programs for job training and employment investment, including work incentive programs, as specified, and establishes local workforce investment boards to perform duties related to the implementation and coordination of local workforce investment activities. Existing law requires local workforce investment boards to spend a minimum percentage of specified funds for adults and dislocated workers on federally identified workforce training programs and allows the boards to leverage specified funds to meet the funding requirements, as specified.This bill would state the intent of the Legislature to enact legislation relating to health care workforce development.The federal Workforce Innovation and Opportunity Act of 2014 provides for workforce investment activities, including activities in which states may participate. Existing law contains various programs for job training and employment investment, including work incentive programs, as specified, and establishes local workforce investment boards to perform duties related to the implementation and coordination of local workforce investment activities. Existing law requires local workforce investment boards to spend a minimum percentage of specified funds for adults and dislocated workers on federally identified workforce training programs and allows the boards to leverage specified funds to meet the funding requirements, as specified.
This bill would state the intent of the Legislature to enact legislation relating to health care workforce development.
(a)The practice of optometry includes the prevention and diagnosis of disorders and dysfunctions of the visual system, and the treatment and management of certain disorders and dysfunctions of the visual system, as well as the provision of habilitative or rehabilitative optometric services, and is the doing of any or all of the following:
(1)The examination of the human eye or eyes, or its or their appendages, and the analysis of the human vision system, either subjectively or objectively.
(2)The determination of the powers or range of human vision and the accommodative and refractive states of the human eye or eyes, including the scope of its or their functions and general condition.
(3)The prescribing or directing the use of, or using, any optical device in connection with ocular exercises, visual training, vision training, or orthoptics.
(4)The prescribing of contact and spectacle lenses for, or the fitting or adaptation of contact and spectacle lenses to, the human eye, including lenses that may be classified as drugs or devices by any law of the United States or of this state.
(5)The use of topical pharmaceutical agents for the purpose of the examination of the human eye or eyes for any disease or pathological condition.
(b)(1)An optometrist who is certified to use therapeutic pharmaceutical agents, pursuant to Section 3041.3, 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, excluding the lacrimal gland, the lacrimal drainage system, and the sclera in patients under 12 years of age.
(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)Nonmalignant ocular surface disease and dry eye disease.
(F)Ocular pain, nonsurgical in cause except when comanaged with the treating physician and surgeon, associated with conditions optometrists are authorized to treat.
(G)Hypotrichosis and blepharitis.
(H)Pursuant to subdivision (e), glaucoma in patients over 18 years of age, as described in subdivision (k).
(2)For purposes of this section, treat means the use of therapeutic pharmaceutical agents, as described in subdivision (c), and the procedures described in subdivision (d).
(c)In diagnosing and treating the conditions listed in subdivision (b), an optometrist certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 may use or prescribe, including for rational off-label purposes, all of the following therapeutic pharmaceutical agents:
(1)Topical pharmaceutical agents for the examination of the human eye or eyes for any disease or pathological condition, including, but not limited to, topical miotics.
(2)Topical lubricants.
(3)Antiallergy agents. In using topical steroid medication for the treatment of ocular allergies, an optometrist shall consult with an ophthalmologist if the patients condition worsens 21 days after diagnosis.
(4)Topical and oral anti-inflammatories.
(5)Topical antibiotic agents.
(6)Topical hyperosmotics.
(7)Topical and oral antiglaucoma agents pursuant to the certification process defined in subdivision (e).
(8)Nonprescription medications used for the rational treatment of an ocular disorder.
(9)Oral antihistamines.
(10)Prescription oral nonsteroidal anti-inflammatory agents.
(11)Oral antibiotics for medical treatment of ocular disease.
(12)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.
(13)Oral analgesics that are not controlled substances.
(14)Codeine with compounds, hydrocodone with compounds, and tramadol as listed in the California Uniform Controlled Substances Act (Division 10 (commencing with Section 11000) of the Health and Safety Code) and the United States Uniform Controlled Substances Act (21 U.S.C. Sec. 801 et seq.). The use of these agents shall be limited to three days, with a referral to an ophthalmologist if the pain persists.
(15)Additional therapeutic pharmaceutical agents pursuant to subdivision (f).
(d)An optometrist who is certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 may also perform all of the following procedures:
(1)Corneal scraping with cultures.
(2)Debridement of corneal epithelia.
(3)Mechanical epilation.
(4)Collection of blood by skin puncture or venipuncture for testing patients suspected of having diabetes.
(5)Suture removal, with prior consultation with the treating physician and surgeon.
(6)Treatment or removal of sebaceous cysts by expression.
(7)Administration of oral fluorescein to patients suspected as having diabetic retinopathy.
(8)Use of an auto-injector to counter anaphylaxis.
(9)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.
(10)A clinical laboratory test or examination classified as waived under the federal Clinical Laboratory Improvement Amendments of 1988 (CLIA) (42 U.S.C. Sec. 263a; Public Law 100-578) and designated in paragraph (9) necessary for the diagnosis of conditions and diseases of the eye or adnexa, or if otherwise specifically authorized by this chapter.
(11)Punctal occlusion by plugs, excluding laser, diathermy, cryotherapy, or other means constituting surgery as defined in this chapter.
(12)The use or prescription of diagnostic or therapeutic contact lenses, including lenses or devices that incorporate a medication or therapy the optometrist is certified to prescribe or provide.
(13)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.
(14)For patients over 12 years of age, lacrimal irrigation and dilation, excluding probing of the nasal lacrimal tract. 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 of 10 procedures under the supervision of an ophthalmologist as confirmed by the ophthalmologist. Any optometrist who graduated from an accredited school of optometry on or after May 1, 2000, shall be exempt from the certification requirement contained in this paragraph.
(15)Intravenous injection for the purpose of performing ocular angiography at the direction of an ophthalmologist as part of an active treatment plan in a setting where a physician and surgeon is immediately available.
(16)Skin testing to diagnose ocular allergies, limited to the superficial layer of the skin.
(17)Use of any noninvasive medical device or technology authorized pursuant to subdivision (f).
(e)An optometrist certified pursuant to Section 3041.3 shall be certified for the treatment of glaucoma, as described in subdivision (k), in patients over 18 years of age after the optometrist meets the following applicable requirements:
(1)For licensees who graduated from an accredited school of optometry on or after May 1, 2008, submission of proof of graduation from that institution.
(2)For licensees who were certified to treat glaucoma under this section prior to January 1, 2009, submission of proof of completion of that certification program.
(3)For licensees who completed a didactic course of not less than 24 hours in the diagnosis, pharmacological, and other treatment and management of glaucoma, submission of proof of satisfactory completion of the case management requirements for certification established by the board.
(4)For licensees who graduated from an accredited school of optometry on or before May 1, 2008, and who are not described in paragraph (2) or (3), submission of proof of satisfactory completion of the requirements for certification established by the board under Chapter 352 of the Statutes of 2008.
(f)(1)Any topical or oral therapeutic pharmaceutical agent, which is not a controlled substance, or noninvasive medical device or technology that is not expressly authorized for use or prescription by an optometrist certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 shall be deemed to be authorized if it has received a United States Food and Drug Administration approved indication for the diagnosis or treatment of a condition authorized by this chapter. A licensee shall successfully complete any clinical training imposed by a related manufacturer prior to using any of those therapeutic pharmaceutical agents or noninvasive medical devices or technologies.
(2)Any other topical or oral therapeutic pharmaceutical agent, which is not a controlled substance, or noninvasive medical device or technology that is not expressly authorized for use or prescription by an optometrist certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 and does not meet the requirements in paragraph (1) shall be deemed authorized if approved by the board through regulation for the rational treatment of a condition authorized by this chapter. Any regulation under this paragraph shall require a licensee to successfully complete an appropriate amount of clinical training to qualify to use each topical or oral therapeutic pharmaceutical agent or noninvasive medical device or technology approved by the board pursuant to this paragraph.
(3)This subdivision shall not be construed to authorize any of the following:
(A)Any therapeutic pharmaceutical agent, medical device, or technology involving cutting, altering, or otherwise infiltrating human tissue by any means.
(B)A clinical laboratory test or imaging study not authorized by paragraphs (1) to (16), inclusive, of subdivision (d).
(C)Treatment of any disease or condition that could not be treated by an optometrist before January 1, 2018.
(g)(1)An optometrist certified pursuant to Section 3041.3 shall be certified for the administration of immunizations after the optometrist meets all of the following requirements:
(A)Completes an immunization training program endorsed by the federal Centers for Disease Control and Prevention (CDC) or the Accreditation Council for Pharmacy Education 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.
(C)Complies with all state and federal recordkeeping and reporting requirements, including providing documentation to the patients primary care provided and entering information in the appropriate immunization registry designated by the immunization branch of the State Department of Public Health.
(D)Applies for an immunization certificate on a board-approved form.
(2)For the purposes of this section, immunization means 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.
(h)Other than for prescription ophthalmic devices described in subdivision (b) of Section 2541, any dispensing of a therapeutic pharmaceutical agent by an optometrist shall be without charge.
(i)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. Surgery does not include those procedures specified in paragraphs (1) to (15), inclusive, of subdivision (d). This subdivision does not limit an optometrists authority to utilize diagnostic laser and ultrasound technology within his or her scope of practice.
(j)An optometrist licensed under this chapter is subject to the provisions of Section 2290.5 for purposes of practicing telehealth.
(k)For purposes of this chapter, glaucoma means either of the following:
(1)All primary open-angle glaucoma.
(2)Exfoliation and pigmentary glaucoma.
(3)(A)Steroid induced glaucoma.
(B)If an optometrist treats a patient for steroid induced glaucoma the optometrist shall promptly notify the prescriber of the steroid medication if the prescriber did not refer the patient to the optometrist for treatment.
(l)For purposes of this chapter, adnexa means ocular adnexa.
(m)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.
SEC. 2.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the California Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to protect the health and well-being of the public by allowing appropriately trained optometrists to administer immunizations, it is necessary for this act to take effect immediately.
(a)The practice of optometry includes the prevention and diagnosis of disorders and dysfunctions of the visual system, and the treatment and management of certain disorders and dysfunctions of the visual system, as well as the provision of habilitative or rehabilitative optometric services, and is the doing of any or all of the following:
(1)The examination of the human eye or eyes, or its or their appendages, and the analysis of the human vision system, either subjectively or objectively.
(2)The determination of the powers or range of human vision and the accommodative and refractive states of the human eye or eyes, including the scope of its or their functions and general condition.
(3)The prescribing or directing the use of, or using, any optical device in connection with ocular exercises, visual training, vision training, or orthoptics.
(4)The prescribing of contact and spectacle lenses for, or the fitting or adaptation of contact and spectacle lenses to, the human eye, including lenses that may be classified as drugs or devices by any law of the United States or of this state.
(5)The use of topical pharmaceutical agents for the purpose of the examination of the human eye or eyes for any disease or pathological condition.
(b)(1)An optometrist who is certified to use therapeutic pharmaceutical agents, pursuant to Section 3041.3, 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, excluding the lacrimal gland, the lacrimal drainage system, and the sclera in patients under 12 years of age.
(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)Nonmalignant ocular surface disease and dry eye disease.
(F)Ocular pain, nonsurgical in cause except when comanaged with the treating physician and surgeon, associated with conditions optometrists are authorized to treat.
(G)Hypotrichosis and blepharitis.
(H)Pursuant to subdivision (e), glaucoma in patients over 18 years of age, as described in subdivision (k).
(2)For purposes of this section, treat means the use of therapeutic pharmaceutical agents, as described in subdivision (c), and the procedures described in subdivision (d).
(c)In diagnosing and treating the conditions listed in subdivision (b), an optometrist certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 may use or prescribe, including for rational off-label purposes, all of the following therapeutic pharmaceutical agents:
(1)Topical pharmaceutical agents for the examination of the human eye or eyes for any disease or pathological condition, including, but not limited to, topical miotics.
(2)Topical lubricants.
(3)Antiallergy agents. In using topical steroid medication for the treatment of ocular allergies, an optometrist shall consult with an ophthalmologist if the patients condition worsens 21 days after diagnosis.
(4)Topical and oral anti-inflammatories.
(5)Topical antibiotic agents.
(6)Topical hyperosmotics.
(7)Topical and oral antiglaucoma agents pursuant to the certification process defined in subdivision (e).
(8)Nonprescription medications used for the rational treatment of an ocular disorder.
(9)Oral antihistamines.
(10)Prescription oral nonsteroidal anti-inflammatory agents.
(11)Oral antibiotics for medical treatment of ocular disease.
(12)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.
(13)Oral analgesics that are not controlled substances.
(14)Codeine with compounds, hydrocodone with compounds, and tramadol as listed in the California Uniform Controlled Substances Act (Division 10 (commencing with Section 11000) of the Health and Safety Code) and the United States Uniform Controlled Substances Act (21 U.S.C. Sec. 801 et seq.). The use of these agents shall be limited to three days, with a referral to an ophthalmologist if the pain persists.
(15)Additional therapeutic pharmaceutical agents pursuant to subdivision (f).
(d)An optometrist who is certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 may also perform all of the following procedures:
(1)Corneal scraping with cultures.
(2)Debridement of corneal epithelia.
(3)Mechanical epilation.
(4)Collection of blood by skin puncture or venipuncture for testing patients suspected of having diabetes.
(5)Suture removal, with prior consultation with the treating physician and surgeon.
(6)Treatment or removal of sebaceous cysts by expression.
(7)Administration of oral fluorescein to patients suspected as having diabetic retinopathy.
(8)Use of an auto-injector to counter anaphylaxis.
(9)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.
(10)A clinical laboratory test or examination classified as waived under the federal Clinical Laboratory Improvement Amendments of 1988 (CLIA) (42 U.S.C. Sec. 263a; Public Law 100-578) and designated in paragraph (9) necessary for the diagnosis of conditions and diseases of the eye or adnexa, or if otherwise specifically authorized by this chapter.
(11)Punctal occlusion by plugs, excluding laser, diathermy, cryotherapy, or other means constituting surgery as defined in this chapter.
(12)The use or prescription of diagnostic or therapeutic contact lenses, including lenses or devices that incorporate a medication or therapy the optometrist is certified to prescribe or provide.
(13)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.
(14)For patients over 12 years of age, lacrimal irrigation and dilation, excluding probing of the nasal lacrimal tract. 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 of 10 procedures under the supervision of an ophthalmologist as confirmed by the ophthalmologist. Any optometrist who graduated from an accredited school of optometry on or after May 1, 2000, shall be exempt from the certification requirement contained in this paragraph.
(15)Intravenous injection for the purpose of performing ocular angiography at the direction of an ophthalmologist as part of an active treatment plan in a setting where a physician and surgeon is immediately available.
(16)Skin testing to diagnose ocular allergies, limited to the superficial layer of the skin.
(17)Use of any noninvasive medical device or technology authorized pursuant to subdivision (f).
(e)An optometrist certified pursuant to Section 3041.3 shall be certified for the treatment of glaucoma, as described in subdivision (k), in patients over 18 years of age after the optometrist meets the following applicable requirements:
(1)For licensees who graduated from an accredited school of optometry on or after May 1, 2008, submission of proof of graduation from that institution.
(2)For licensees who were certified to treat glaucoma under this section prior to January 1, 2009, submission of proof of completion of that certification program.
(3)For licensees who completed a didactic course of not less than 24 hours in the diagnosis, pharmacological, and other treatment and management of glaucoma, submission of proof of satisfactory completion of the case management requirements for certification established by the board.
(4)For licensees who graduated from an accredited school of optometry on or before May 1, 2008, and who are not described in paragraph (2) or (3), submission of proof of satisfactory completion of the requirements for certification established by the board under Chapter 352 of the Statutes of 2008.
(f)(1)Any topical or oral therapeutic pharmaceutical agent, which is not a controlled substance, or noninvasive medical device or technology that is not expressly authorized for use or prescription by an optometrist certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 shall be deemed to be authorized if it has received a United States Food and Drug Administration approved indication for the diagnosis or treatment of a condition authorized by this chapter. A licensee shall successfully complete any clinical training imposed by a related manufacturer prior to using any of those therapeutic pharmaceutical agents or noninvasive medical devices or technologies.
(2)Any other topical or oral therapeutic pharmaceutical agent, which is not a controlled substance, or noninvasive medical device or technology that is not expressly authorized for use or prescription by an optometrist certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 and does not meet the requirements in paragraph (1) shall be deemed authorized if approved by the board through regulation for the rational treatment of a condition authorized by this chapter. Any regulation under this paragraph shall require a licensee to successfully complete an appropriate amount of clinical training to qualify to use each topical or oral therapeutic pharmaceutical agent or noninvasive medical device or technology approved by the board pursuant to this paragraph.
(3)This subdivision shall not be construed to authorize any of the following:
(A)Any therapeutic pharmaceutical agent, medical device, or technology involving cutting, altering, or otherwise infiltrating human tissue by any means.
(B)A clinical laboratory test or imaging study not authorized by paragraphs (1) to (16), inclusive, of subdivision (d).
(C)Treatment of any disease or condition that could not be treated by an optometrist before January 1, 2018.
(g)(1)An optometrist certified pursuant to Section 3041.3 shall be certified for the administration of immunizations after the optometrist meets all of the following requirements:
(A)Completes an immunization training program endorsed by the federal Centers for Disease Control and Prevention (CDC) or the Accreditation Council for Pharmacy Education 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.
(C)Complies with all state and federal recordkeeping and reporting requirements, including providing documentation to the patients primary care provided and entering information in the appropriate immunization registry designated by the immunization branch of the State Department of Public Health.
(D)Applies for an immunization certificate on a board-approved form.
(2)For the purposes of this section, immunization means 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.
(h)Other than for prescription ophthalmic devices described in subdivision (b) of Section 2541, any dispensing of a therapeutic pharmaceutical agent by an optometrist shall be without charge.
(i)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. Surgery does not include those procedures specified in paragraphs (1) to (15), inclusive, of subdivision (d). This subdivision does not limit an optometrists authority to utilize diagnostic laser and ultrasound technology within his or her scope of practice.
(j)An optometrist licensed under this chapter is subject to the provisions of Section 2290.5 for purposes of practicing telehealth.
(k)For purposes of this chapter, glaucoma means either of the following:
(1)All primary open-angle glaucoma.
(2)Exfoliation and pigmentary glaucoma.
(3)(A)Steroid induced glaucoma.
(B)If an optometrist treats a patient for steroid induced glaucoma the optometrist shall promptly notify the prescriber of the steroid medication if the prescriber did not refer the patient to the optometrist for treatment.
(l)For purposes of this chapter, adnexa means ocular adnexa.
(m)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.
SEC. 2.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the California Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to protect the health and well-being of the public by allowing appropriately trained optometrists to administer immunizations, it is necessary for this act to take effect immediately.
(a)The practice of optometry includes the prevention and diagnosis of disorders and dysfunctions of the visual system, and the treatment and management of certain disorders and dysfunctions of the visual system, as well as the provision of habilitative or rehabilitative optometric services, and is the doing of any or all of the following:
(1)The examination of the human eye or eyes, or its or their appendages, and the analysis of the human vision system, either subjectively or objectively.
(2)The determination of the powers or range of human vision and the accommodative and refractive states of the human eye or eyes, including the scope of its or their functions and general condition.
(3)The prescribing or directing the use of, or using, any optical device in connection with ocular exercises, visual training, vision training, or orthoptics.
(4)The prescribing of contact and spectacle lenses for, or the fitting or adaptation of contact and spectacle lenses to, the human eye, including lenses that may be classified as drugs or devices by any law of the United States or of this state.
(5)The use of topical pharmaceutical agents for the purpose of the examination of the human eye or eyes for any disease or pathological condition.
(b)(1)An optometrist who is certified to use therapeutic pharmaceutical agents, pursuant to Section 3041.3, 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, excluding the lacrimal gland, the lacrimal drainage system, and the sclera in patients under 12 years of age.
(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)Nonmalignant ocular surface disease and dry eye disease.
(F)Ocular pain, nonsurgical in cause except when comanaged with the treating physician and surgeon, associated with conditions optometrists are authorized to treat.
(G)Hypotrichosis and blepharitis.
(H)Pursuant to subdivision (e), glaucoma in patients over 18 years of age, as described in subdivision (k).
(2)For purposes of this section, treat means the use of therapeutic pharmaceutical agents, as described in subdivision (c), and the procedures described in subdivision (d).
(c)In diagnosing and treating the conditions listed in subdivision (b), an optometrist certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 may use or prescribe, including for rational off-label purposes, all of the following therapeutic pharmaceutical agents:
(1)Topical pharmaceutical agents for the examination of the human eye or eyes for any disease or pathological condition, including, but not limited to, topical miotics.
(2)Topical lubricants.
(3)Antiallergy agents. In using topical steroid medication for the treatment of ocular allergies, an optometrist shall consult with an ophthalmologist if the patients condition worsens 21 days after diagnosis.
(4)Topical and oral anti-inflammatories.
(5)Topical antibiotic agents.
(6)Topical hyperosmotics.
(7)Topical and oral antiglaucoma agents pursuant to the certification process defined in subdivision (e).
(8)Nonprescription medications used for the rational treatment of an ocular disorder.
(9)Oral antihistamines.
(10)Prescription oral nonsteroidal anti-inflammatory agents.
(11)Oral antibiotics for medical treatment of ocular disease.
(12)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.
(13)Oral analgesics that are not controlled substances.
(14)Codeine with compounds, hydrocodone with compounds, and tramadol as listed in the California Uniform Controlled Substances Act (Division 10 (commencing with Section 11000) of the Health and Safety Code) and the United States Uniform Controlled Substances Act (21 U.S.C. Sec. 801 et seq.). The use of these agents shall be limited to three days, with a referral to an ophthalmologist if the pain persists.
(15)Additional therapeutic pharmaceutical agents pursuant to subdivision (f).
(d)An optometrist who is certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 may also perform all of the following procedures:
(1)Corneal scraping with cultures.
(2)Debridement of corneal epithelia.
(3)Mechanical epilation.
(4)Collection of blood by skin puncture or venipuncture for testing patients suspected of having diabetes.
(5)Suture removal, with prior consultation with the treating physician and surgeon.
(6)Treatment or removal of sebaceous cysts by expression.
(7)Administration of oral fluorescein to patients suspected as having diabetic retinopathy.
(8)Use of an auto-injector to counter anaphylaxis.
(9)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.
(10)A clinical laboratory test or examination classified as waived under the federal Clinical Laboratory Improvement Amendments of 1988 (CLIA) (42 U.S.C. Sec. 263a; Public Law 100-578) and designated in paragraph (9) necessary for the diagnosis of conditions and diseases of the eye or adnexa, or if otherwise specifically authorized by this chapter.
(11)Punctal occlusion by plugs, excluding laser, diathermy, cryotherapy, or other means constituting surgery as defined in this chapter.
(12)The use or prescription of diagnostic or therapeutic contact lenses, including lenses or devices that incorporate a medication or therapy the optometrist is certified to prescribe or provide.
(13)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.
(14)For patients over 12 years of age, lacrimal irrigation and dilation, excluding probing of the nasal lacrimal tract. 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 of 10 procedures under the supervision of an ophthalmologist as confirmed by the ophthalmologist. Any optometrist who graduated from an accredited school of optometry on or after May 1, 2000, shall be exempt from the certification requirement contained in this paragraph.
(15)Intravenous injection for the purpose of performing ocular angiography at the direction of an ophthalmologist as part of an active treatment plan in a setting where a physician and surgeon is immediately available.
(16)Skin testing to diagnose ocular allergies, limited to the superficial layer of the skin.
(17)Use of any noninvasive medical device or technology authorized pursuant to subdivision (f).
(e)An optometrist certified pursuant to Section 3041.3 shall be certified for the treatment of glaucoma, as described in subdivision (k), in patients over 18 years of age after the optometrist meets the following applicable requirements:
(1)For licensees who graduated from an accredited school of optometry on or after May 1, 2008, submission of proof of graduation from that institution.
(2)For licensees who were certified to treat glaucoma under this section prior to January 1, 2009, submission of proof of completion of that certification program.
(3)For licensees who completed a didactic course of not less than 24 hours in the diagnosis, pharmacological, and other treatment and management of glaucoma, submission of proof of satisfactory completion of the case management requirements for certification established by the board.
(4)For licensees who graduated from an accredited school of optometry on or before May 1, 2008, and who are not described in paragraph (2) or (3), submission of proof of satisfactory completion of the requirements for certification established by the board under Chapter 352 of the Statutes of 2008.
(f)(1)Any topical or oral therapeutic pharmaceutical agent, which is not a controlled substance, or noninvasive medical device or technology that is not expressly authorized for use or prescription by an optometrist certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 shall be deemed to be authorized if it has received a United States Food and Drug Administration approved indication for the diagnosis or treatment of a condition authorized by this chapter. A licensee shall successfully complete any clinical training imposed by a related manufacturer prior to using any of those therapeutic pharmaceutical agents or noninvasive medical devices or technologies.
(2)Any other topical or oral therapeutic pharmaceutical agent, which is not a controlled substance, or noninvasive medical device or technology that is not expressly authorized for use or prescription by an optometrist certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 and does not meet the requirements in paragraph (1) shall be deemed authorized if approved by the board through regulation for the rational treatment of a condition authorized by this chapter. Any regulation under this paragraph shall require a licensee to successfully complete an appropriate amount of clinical training to qualify to use each topical or oral therapeutic pharmaceutical agent or noninvasive medical device or technology approved by the board pursuant to this paragraph.
(3)This subdivision shall not be construed to authorize any of the following:
(A)Any therapeutic pharmaceutical agent, medical device, or technology involving cutting, altering, or otherwise infiltrating human tissue by any means.
(B)A clinical laboratory test or imaging study not authorized by paragraphs (1) to (16), inclusive, of subdivision (d).
(C)Treatment of any disease or condition that could not be treated by an optometrist before January 1, 2018.
(g)(1)An optometrist certified pursuant to Section 3041.3 shall be certified for the administration of immunizations after the optometrist meets all of the following requirements:
(A)Completes an immunization training program endorsed by the federal Centers for Disease Control and Prevention (CDC) or the Accreditation Council for Pharmacy Education 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.
(C)Complies with all state and federal recordkeeping and reporting requirements, including providing documentation to the patients primary care provided and entering information in the appropriate immunization registry designated by the immunization branch of the State Department of Public Health.
(D)Applies for an immunization certificate on a board-approved form.
(2)For the purposes of this section, immunization means 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.
(h)Other than for prescription ophthalmic devices described in subdivision (b) of Section 2541, any dispensing of a therapeutic pharmaceutical agent by an optometrist shall be without charge.
(i)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. Surgery does not include those procedures specified in paragraphs (1) to (15), inclusive, of subdivision (d). This subdivision does not limit an optometrists authority to utilize diagnostic laser and ultrasound technology within his or her scope of practice.
(j)An optometrist licensed under this chapter is subject to the provisions of Section 2290.5 for purposes of practicing telehealth.
(k)For purposes of this chapter, glaucoma means either of the following:
(1)All primary open-angle glaucoma.
(2)Exfoliation and pigmentary glaucoma.
(3)(A)Steroid induced glaucoma.
(B)If an optometrist treats a patient for steroid induced glaucoma the optometrist shall promptly notify the prescriber of the steroid medication if the prescriber did not refer the patient to the optometrist for treatment.
(l)For purposes of this chapter, adnexa means ocular adnexa.
(m)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.
SEC. 2.This act is an urgency statute necessary for the immediate preservation of the public peace, health, or safety within the meaning of Article IV of the California Constitution and shall go into immediate effect. The facts constituting the necessity are:
In order to protect the health and well-being of the public by allowing appropriately trained optometrists to administer immunizations, it is necessary for this act to take effect immediately.
(a)The practice of optometry includes the prevention and diagnosis of disorders and dysfunctions of the visual system, and the treatment and management of certain disorders and dysfunctions of the visual system, as well as the provision of habilitative or rehabilitative optometric services, and is the doing of any or all of the following:
(1)The examination of the human eye or eyes, or its or their appendages, and the analysis of the human vision system, either subjectively or objectively.
(2)The determination of the powers or range of human vision and the accommodative and refractive states of the human eye or eyes, including the scope of its or their functions and general condition.
(3)The prescribing or directing the use of, or using, any optical device in connection with ocular exercises, visual training, vision training, or orthoptics.
(4)The prescribing of contact and spectacle lenses for, or the fitting or adaptation of contact and spectacle lenses to, the human eye, including lenses that may be classified as drugs or devices by any law of the United States or of this state.
(5)The use of topical pharmaceutical agents for the purpose of the examination of the human eye or eyes for any disease or pathological condition.
(b)(1)An optometrist who is certified to use therapeutic pharmaceutical agents, pursuant to Section 3041.3, 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, excluding the lacrimal gland, the lacrimal drainage system, and the sclera in patients under 12 years of age.
(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)Nonmalignant ocular surface disease and dry eye disease.
(F)Ocular pain, nonsurgical in cause except when comanaged with the treating physician and surgeon, associated with conditions optometrists are authorized to treat.
(G)Hypotrichosis and blepharitis.
(H)Pursuant to subdivision (e), glaucoma in patients over 18 years of age, as described in subdivision (j). (k).
(2)For purposes of this section, treat means the use of therapeutic pharmaceutical agents, as described in subdivision (c), and the procedures described in subdivision (d).
(c)In diagnosing and treating the conditions listed in subdivision (b), an optometrist certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 may use or prescribe, including for rational off-label purposes, all of the following therapeutic pharmaceutical agents:
(1)Topical pharmaceutical agents for the examination of the human eye or eyes for any disease or pathological condition, including, but not limited to, topical miotics.
(2)Topical lubricants.
(3)Antiallergy agents. In using topical steroid medication for the treatment of ocular allergies, an optometrist shall consult with an ophthalmologist if the patients condition worsens 21 days after diagnosis.
(4)Topical and oral anti-inflammatories.
(5)Topical antibiotic agents.
(6)Topical hyperosmotics.
(7)Topical and oral antiglaucoma agents pursuant to the certification process defined in subdivision (e).
(8)Nonprescription medications used for the rational treatment of an ocular disorder.
(9)Oral antihistamines.
(10)Prescription oral nonsteroidal anti-inflammatory agents.
(11)Oral antibiotics for medical treatment of ocular disease.
(12)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.
(13)Oral analgesics that are not controlled substances.
(14)Codeine with compounds, hydrocodone with compounds, and tramadol as listed in the California Uniform Controlled Substances Act (Division 10 (commencing with Section 11000) of the Health and Safety Code) and the United States Uniform Controlled Substances Act (21 U.S.C. Sec. 801 et seq.). The use of these agents shall be limited to three days, with a referral to an ophthalmologist if the pain persists.
(15)Additional therapeutic pharmaceutical agents pursuant to subdivision (f).
(d)An optometrist who is certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 may also perform all of the following procedures:
(1)Corneal scraping with cultures.
(2)Debridement of corneal epithelia.
(3)Mechanical epilation.
(4)Collection of blood by skin puncture or venipuncture for testing patients suspected of having diabetes.
(5)Suture removal, with prior consultation with the treating physician and surgeon.
(6)Treatment or removal of sebaceous cysts by expression.
(7)Administration of oral fluorescein to patients suspected as having diabetic retinopathy.
(8)Use of an auto-injector to counter anaphylaxis.
(9)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.
(10)A clinical laboratory test or examination classified as waived under the federal Clinical Laboratory Improvement Amendments of 1988 (CLIA) (42 U.S.C. Sec. 263a; Public Law 100-578) and designated as waived in paragraph (9) necessary for the diagnosis of conditions and diseases of the eye or adnexa, or if otherwise specifically authorized by this chapter.
(11)Punctal occlusion by plugs, excluding laser, diathermy, cryotherapy, or other means constituting surgery as defined in this chapter.
(12)The use or prescription of diagnostic or therapeutic contact lenses, including lenses or devices that incorporate a medication or therapy the optometrist is certified to prescribe or provide.
(13)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.
(14)For patients over 12 years of age, lacrimal irrigation and dilation, excluding probing of the nasal lacrimal tract. 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 of 10 procedures under the supervision of an ophthalmologist as confirmed by the ophthalmologist. Any optometrist who graduated from an accredited school of optometry on or after May 1, 2000, shall be exempt from the certification requirement contained in this paragraph.
(15)Intravenous injection for the purpose of performing ocular angiography at the direction of an ophthalmologist as part of an active treatment plan in a setting where a physician and surgeon is immediately available.
(16)Skin testing to diagnose ocular allergies, limited to the superficial layer of the skin.
(17)Use of any noninvasive medical device or technology authorized pursuant to subdivision (f).
(e)An optometrist certified pursuant to Section 3041.3 shall be certified for the treatment of glaucoma, as described in subdivision (j), (k), in patients over 18 years of age after the optometrist meets the following applicable requirements:
(1)For licensees who graduated from an accredited school of optometry on or after May 1, 2008, submission of proof of graduation from that institution.
(2)For licensees who were certified to treat glaucoma under this section prior to January 1, 2009, submission of proof of completion of that certification program.
(3)For licensees who completed a didactic course of not less than 24 hours in the diagnosis, pharmacological, and other treatment and management of glaucoma, submission of proof of satisfactory completion of the case management requirements for certification established by the board.
(4)For licensees who graduated from an accredited school of optometry on or before May 1, 2008, and who are not described in paragraph (2) or (3), submission of proof of satisfactory completion of the requirements for certification established by the board under Chapter 352 of the Statutes of 2008.
(f)(1)Any topical or oral therapeutic pharmaceutical agent, which is not a controlled substance, or noninvasive medical device or technology that is not expressly authorized for use or prescription by an optometrist certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 shall be deemed to be authorized if it has received a United States Food and Drug Administration approved indication for the diagnosis or treatment of a condition authorized by this chapter. A licensee shall successfully complete any clinical training imposed by a related manufacturer prior to using any of those therapeutic pharmaceutical agents or noninvasive medical devices or technologies.
(2)Any other topical or oral therapeutic pharmaceutical agent, which is not a controlled substance, or noninvasive medical device or technology that is not expressly authorized for use or prescription by an optometrist certified to use therapeutic pharmaceutical agents pursuant to Section 3041.3 and does not meet the requirements in paragraph (1) shall be deemed authorized if approved by the board through regulation for the rational treatment of a condition authorized by this chapter. Any regulation under this paragraph shall require a licensee to successfully complete an appropriate amount of clinical training to qualify to use each topical or oral therapeutic pharmaceutical agent or noninvasive medical device or technology approved by the board pursuant to this paragraph.
(3)This subdivision shall not be construed to authorize any of the following:
(A)Any therapeutic pharmaceutical agent, medical device, or technology involving cutting, altering, or otherwise infiltrating human tissue by any means.
(B)A clinical laboratory test or imaging study not authorized by paragraphs (1) to (16), inclusive, of subdivision (d).
(C)Treatment of any disease or condition that could not be treated by an optometrist before January 1, 2018.
(g)(1)An optometrist certified pursuant to Section 3014.3 3041.3 shall be certified for the administration of immunizations after the optometrist meets all of the following requirements:
(A)Completes an immunization training program endorsed by the federal Centers for Disease Control and Prevention (CDC) or the Accreditation Council for Pharmacy Education that, at a minimum, includes hands-on injection technique, clinical evaluation of indications and contradications contraindications of vaccines, and the recognition and treatment of emergency reactions to vaccines, and maintains that training.
(B)Is certified in basic life support.
(C)Complies with all state and federal recordkeeping and reporting requirements, including providing documentation to the patients primary care provided and entering information in the appropriate immunization registry designated by the immunization branch of the State Department of Public Health.
(D)Applies for an immunization certificate on a board-approved form.
(2)For the purposes of this section, immunization means 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.
(h)Other than for prescription ophthalmic devices described in subdivision (b) of Section 2541, any dispensing of a therapeutic pharmaceutical agent by an optometrist shall be without charge.
(i)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. Surgery does not include those procedures specified in paragraphs (1) to (15), inclusive, of subdivision (d). This subdivision does not limit an optometrists authority to utilize diagnostic laser and ultrasound technology within his or her scope of practice.
(j)An optometrist licensed under this chapter is subject to the provisions of Section 2290.5 for purposes of practicing telehealth.
(k)For purposes of this chapter, glaucoma means either of the following:
(1)All primary open-angle glaucoma.
(2)Exfoliation and pigmentary glaucoma.
(3)(A)Steroid induced glaucoma.
(B)If an optometrist treats a patient for steroid induced glaucoma the optometrist shall promptly notify the prescriber of the steroid medication if the prescriber did not refer the patient to the optometrist for treatment.
(l)For purposes of this chapter, adnexa means ocular adnexa.
(m)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.
SECTION 1.Section 704 of the Business and Professions Code is amended to read:704.In order for the holder of an inactive license or certificate issued pursuant to this article to restore his or her license or certificate to an active status, the holder of an inactive license or certificate shall comply with both the following:(a)Pay the renewal fee; provided, that the renewal fee shall be waived for a healing arts licensee who certifies to the board that license restoration is for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation that provides medical services to indigent patients in medically underserved or critical-need population areas of the state.(b)If the board requires completion of continuing education for renewers of an active license or certificate, complete continuing education equivalent to that required for a single license renewal period.In order for the holder of an inactive license or certificate issued pursuant to this article to restore his or her license or certificate to an active status, the holder of an inactive license or certificate shall comply with all both the following:
(a)Pay the renewal fee; provided, that the renewal fee shall be waived for a physician and surgeon healing arts licensee who certifies to the Medical Board of California board that license restoration is for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation which that provides medical services to indigent patients in medically underserved or critical-need population areas of the state.
(b)If the board requires completion of continuing education for renewers of an active license or certificate, complete continuing education equivalent to that required for a single license renewal period.
SECTION 1.It is the intent of the Legislature to enact legislation relating to health care workforce development.It is the intent of the Legislature to enact legislation relating to health care workforce development.
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Date
|
Status
|
|---|---|
| Sep 10, 2018 | Chaptered by Secretary of State. Chapter 330, Statutes of 2018. |
| Sep 10, 2018 | Approved by the Governor. |
| Aug 30, 2018 | Enrolled and presented to the Governor at 5 p.m. |
| Aug 24, 2018 | Urgency clause adopted. |
| Aug 22, 2018 | From committee: That the Assembly amendments be concurred in. (Ayes 9. Noes 0.) |
| Aug 21, 2018 | Set for hearing August 22. |
| Aug 20, 2018 | From committee: Be re-referred to Com. on B., P. & E.D. pursuant to Senate Rule 29.10(d). (Ayes 5. Noes 0.) Re-referred to Com. on B., P. & E.D. |
| Aug 20, 2018 | Re-referred to Com. on RLS. pursuant to Senate Rule 29.10(d). |
| Aug 16, 2018 | In Senate. Concurrence in Assembly amendments pending. |
| Aug 16, 2018 | Read third time. Urgency clause adopted. Passed. Ordered to the Senate. |
| Aug 9, 2018 | Read second time. Ordered to consent calendar. |
| Aug 8, 2018 | From committee: Do pass. Ordered to consent calendar. (Ayes 17. Noes 0.) (August 8). |
| Jun 27, 2018 | Read second time and amended. Re-referred to Com. on APPR. |
| Jun 26, 2018 | From committee: Do pass as amended and re-refer to Com. on APPR. with recommendation: To consent calendar. (Ayes 19. Noes 0.) (June 26). |
| Jun 11, 2018 | From committee with author's amendments. Read second time and amended. Re-referred to Com. on B. & P. |
| Jun 15, 2017 | Referred to Com. on B. & P. |
| Jun 1, 2017 | In Assembly. Read first time. Held at Desk. |
| May 31, 2017 | Read third time. Passed. (Ayes 40. Noes 0. Page 1358.) Ordered to the Assembly. |
| May 26, 2017 | Ordered to special consent calendar. |
| May 26, 2017 | Read second time. Ordered to third reading. |
| May 25, 2017 | From committee: Do pass. (Ayes 7. Noes 0. Page 1189.) (May 25). |
| May 19, 2017 | Set for hearing May 25. |
| May 15, 2017 | May 15 hearing: Placed on APPR. suspense file. |
| May 4, 2017 | Set for hearing May 15. |
| Apr 25, 2017 | From committee: Do pass and re-refer to Com. on APPR. with recommendation: To consent calendar. (Ayes 9. Noes 0. Page 825.) (April 24). Re-referred to Com. on APPR. |
| Apr 20, 2017 | Set for hearing April 24 in B., P. & E.D. pending receipt. |
| Apr 19, 2017 | Re-referred to Com. on B., P. & E.D. |
| Apr 17, 2017 | From committee with author's amendments. Read second time and amended. Re-referred to Com. on RLS. |
| Mar 9, 2017 | Referred to Com. on RLS. |
| Feb 21, 2017 | From printer. May be acted upon on or after March 23. |
| Feb 17, 2017 | Introduced. Read first time. To Com. on RLS. for assignment. To print. |
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Date
|
Description
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Location
|
Votes
|
|
|---|---|---|---|---|
| Aug 24, 2018 | Unfinished Business SB762 Hernandez et al. Urgency Clause Concurrence | Senate Floor |
Passed |
|
| Aug 22, 2018 | That the Assembly amendments be concurred in | Senate Standing Committee on Business, Professions and Economic Development |
Passed |
|
| Aug 16, 2018 | SB 762 Hernandez Consent Calendar Second Day Regular Session | Assembly Floor |
Passed |
|
| Aug 8, 2018 | Do pass. To Consent Calendar. | Assembly Standing Committee on Appropriations |
Passed |
|
| Jun 26, 2018 | Do pass as amended, and be re-referred to the Committee on [Appropriations] with recommendation: To Consent Calendar | Assembly Standing Committee on Business and Professions |
Passed |
|
| May 31, 2017 | Special Consent Calendar # SB762 | Senate Floor |
Passed |
|
| May 25, 2017 | Do pass | Senate Standing Committee on Appropriations |
Passed |
|
| May 15, 2017 | Placed on suspense file | Senate Standing Committee on Appropriations |
Passed |
|
| Apr 24, 2017 | Do pass, but first be re-referred to the Committee on [Appropriations] with the recommendation: To Consent Calendar | Senate Standing Committee on Business, Professions and Economic Development |
Passed |
This list shows positions taken on this bill by organizations on the date displayed, which is linked to the original source.
Positions by individuals are not included.
|
Organization
|
Position
|
Date
|
|---|---|---|
| California Opimetric Association | * Support | Aug 22, 2018 |
| California Optometric Association | ** Support | Aug 21, 2018 |
| Los Angeles County Emergency Medical Services Agency | * Against | Apr 19, 2017 |
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | SB |
UNFINISHED BUSINESS
Bill No: SB 762
:
PRIOR VOTES NOT RELEVANT
SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 9-0, 8/22/18 (Pursuant to Senate Rule 29.10)
AYES: Hill, Fuller, Allen, Dodd, Galgiani, Glazer, Hernandez, Pan, Wilk
ASSEMBLY FLOOR: 76-0, 8/16/18 (Consent) - See last page for vote
SUBJECT: Optometry: administration of immunizations
SOURCE: California Optometric Association
DIGEST:
This bill allows an optometrist to take an immunization training program endorsed by the Accreditation Council for Pharmacy Education towards certification to administer immunizations.
Assembly Amendments
create a new bill.
Existing law:
- Establishes certification requirements to use therapeutic pharmaceutical agents (TPA) and certain requirements for a TPA-certified optometrist to be certified to administer specified immunizations. (BPC § 3041.3)
- Authorizes a certified optometrist to administer the following immunizations: 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. (BPC § 3041)
This bill allows an optometrist to take an immunization training program endorsed by the Accreditation Council for Pharmacy Education towards certification for the administration of immunizations and states that, in order to protect the health and well-being of the public by allowing appropriately trained optometrists to administer immunizations, this bill should take place immediately.
Background
An optometrist (Doctor of Optometry or O.D.) is an independent primary health care professional for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures, as well as identify related systemic conditions affecting the eye. ODs prescribe medications, low vision rehabilitation, vision therapy, spectacle lenses, contact lenses, and perform certain surgical procedures. Optometrists have a narrower scope of practice than do ophthalmologists, but are held to the identical standard of care for the same treatments they provide.
Optometrists are trained to diagnose mild to severe eye problems such as serious eye infections, inflammations of the eye, trauma, foreign bodies and glaucoma. They also examine the eye for vision prescription and corrective lenses. Optometrists may also pursue any of five additional state certifications to perform certain advanced procedures: use of diagnostic pharmaceutical agents (DPA); use of therapeutic pharmaceutical agents (TPA); lacrimal irrigation and dilation for individuals over the age of 12 + TPA (TPL); diagnosis and treatment of open angle glaucoma for adults + TPA (TPG); and a combination of TPA, TPL and TPG.
AB 443 (Salas, Chapter 549, Statutes of 2017) expanded the optometry scope of practice to include the administration of certain vaccines after completing specified training, including the requirement of a CDC-endorsed program. However, the CDC does not endorse a program that meets the requirements of current law, so this bill amends the relevant code to include courses endorsed by the Accreditation Council for Pharmacy Education.
FISCAL EFFECT: Appropriation: Fiscal Com.: Local:
According to the Assembly Appropriations Committee analysis dated August 8, 2018, this bill has negligible fiscal effects.
California Optometric Association (source)
OPPOSITION: (Verified 8/22/18)
None received
ARGUMENTS IN SUPPORT: The California Optometric Association states that this bill would enact necessary cleanup language that adds an additional valid option for immunization training to the Optometric Practice Act.
ASSEMBLY FLOOR: 76-0, 8/16/18
AYES: Acosta, Aguiar-Curry, Travis Allen, Arambula, Baker, Berman, Bigelow, Bonta, Brough, Burke, Caballero, Calderon, Carrillo, Cervantes, Chau, Chávez, Chen, Chiu, Choi, Chu, Cooley, Cooper, Cunningham, Dahle, Daly, Eggman, Flora, Fong, Frazier, Friedman, Gabriel, Gallagher, Eduardo Garcia, Gipson, Gloria, Gonzalez Fletcher, Gray, Grayson, Harper, Holden, Irwin, Jones-Sawyer, Kalra, Kamlager-Dove, Kiley, Lackey, Levine, Limón, Maienschein, Mathis, Mayes, Medina, Melendez, Mullin, Muratsuchi, Nazarian, Obernolte, O'Donnell, Patterson, Quirk, Quirk-Silva, Reyes, Rivas, Rodriguez, Rubio, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Voepel, Waldron, Weber, Wood, Rendon
NO VOTE RECORDED: Bloom, Cristina Garcia, Low, McCarty
8/22/18 15:42:25
**** END ****
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2017 - 2018 Regular
Bill No: SB 762 Hearing Date: August 22, 2018
Author: | Hernandez | ||
Version: |
| ||
Urgency: | Fiscal: | ||
Consultant: | |||
Subject: Optometry: administration of immunizations.
SUMMARY:
Allows an optometrist to take an immunization training program endorsed by the Accreditation Council for Pharmacy Education towards certification to administer immunizations.
Existing law:
- Establishes the California Board of Optometry (CBO) to administer and enforce the Optometry Practice Act (Act). (Business and Professions Code (BPC) § 3010.5)
- Defines the practice of optometry as including the prevention and diagnosis of disorders and dysfunctions of the visual system, and the treatment and management of certain disorders and dysfunctions of the visual system, as well as the provision of rehabilitative optometric services. (BPC § 3041(a))
- Establishes certification requirements to use therapeutic pharmaceutical agents (TPA). (BPC § 3041.3)
- Establishes the following requirements for a TPA-certified optometrist to be certified to administer specified immunizations:
- 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.
- Is certified in basic life support.
- Complies with all state and federal recordkeeping and reporting requirements, including providing documentation to the patient’s primary care provided and entering information in the appropriate immunization registry designated by the immunization branch of the State Department of Public Health.
- Applies for an immunization certificate on a board-approved form.
- Authorizes a certified optometrist to administer the following immunizations: 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. (BPC § 3041)
This bill:
- Allows an optometrist to take an immunization training program endorsed by the Accreditation Council for Pharmacy Education towards certification for the administration of immunizations.
- Makes technical changes.
- States that, in order to protect the health and well-being of the public by allowing appropriately trained optometrists to administer immunizations, this bill should take place immediately.
FISCAL EFFECT:
According to the Assembly Appropriations Committee analysis dated August 8, 2018, this bill has negligible fiscal effects.
COMMENTS:
- Purpose. This bill is sponsored by the California Optometric Association. According to the Author’s office, “Current law requires an optometrist who has been certified to use therapeutic pharmaceutical agents to be certified for the administration of immunizations by completing an immunization training program that is endorsed by the federal CDC. However, the CDC does not endorse any training program. This effectively prevents optometrists from administering immunizations as allowed in law.”
- The Practice of Optometry. An optometrist (Doctor of Optometry or O.D.) is an independent primary health care professional for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures, as well as identify related systemic conditions affecting the eye. ODs prescribe medications, low vision rehabilitation, vision therapy, spectacle lenses, contact lenses, and perform certain surgical procedures. Optometrists have a narrower scope of practice than do ophthalmologists, but are held to the identical standard of care for the same treatments they provide.
An O.D. degree requires both an undergraduate education in a college or university and four years of professional education at a college of optometry. Some optometrists also undertake an optional one year non-surgical residency program to enhance their experience in a particular area. Students graduate with 2,500-3,000 patient encounters; these include a mix of post-surgical, medical and routine visits.
In order to be licensed to practice by the California Board of Optometry, an individual must obtain an O.D. degree, pass the three part National Board of Examiners in Optometry examination and the California Optometric State Law Examination. There are currently 9,100 optometrists in practice in California.
Optometrists are trained to diagnose mild to severe eye problems such as serious eye infections, inflammations of the eye, trauma, foreign bodies and glaucoma. They also examine the eye for vision prescription and corrective lenses. Optometrists may also pursue any of five additional state certifications to perform certain advanced procedures: use of diagnostic pharmaceutical agents (DPA); use of therapeutic pharmaceutical agents (TPA); lacrimal irrigation and dilation for individuals over the age of 12 + TPA (TPL); diagnosis and treatment of open angle glaucoma for adults + TPA (TPG); and a combination of TPA, TPL and TPG.
- Immunization Requirements. AB 443 (Salas, Chapter 549, Statutes of 2017) expanded the optometry scope of practice to include the administration of certain vaccines after completing specified training, including the requirement of a CDC-endorsed program. However, the CDC does not endorse a program that meets the requirements of current law, so this bill amends the relevant code to include courses endorsed by the Accreditation Council for Pharmacy Education.
- Prior Related Legislation. AB 443 (Salas, Chapter 549, Statutes of 2017) expanded the optometry scope of practice to include further independence from physicians and surgeons, the administration of specified vaccines, and the treatment of additional conditions, as specified.
SB 622 (Hernandez) of 2016 would have expanded the scope of practice for optometrists to include the use noninvasive, nonsurgical technology to treat conditions authorized by the Act, perform laser and minor procedures, and administer certain vaccines. (Status: This bill was held in the Assembly Business and Professions Committee.)
SB 492 (Hernandez) of 2014 would have authorized an optometrist to administer influenza and herpes zoster virus (shingles) immunizations for persons 18 years of age and older after completing a training program. (Status: This bill was held on the Assembly Floor.)
- Arguments in Support. “The California Optometric Association (COA) is pleased to support SB 762 authored by Senator Ed Hernandez. This bill would enact necessary cleanup language that adds an additional valid option for immunization training to the Optometric Practice Act.”
SUPPORT AND OPPOSITION:
Support:
California Optometric Association (Sponsor)
Opposition:
None on file.
-- END --
Date of Hearing: August 8, 2018
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez Fletcher, Chair
SBPCA Bill Id:SB 762
Author:(Hernandez) – As Amended Ver:June 27, 2018
Policy Committee: | Business and Professions | Vote: | 19 - 0 |
Urgency: Yes State Mandated Local Program: No Reimbursable: No
SUMMARY:
This urgency bill makes a technical correction to a recently enacted law that allowed for an expanded scope of practice for optometrists. Specifically, this bill allows a specified immunization training program to be endorsed by the Accreditation Council for Pharmacy Education.
FISCAL EFFECT:
Negligible.
COMMENTS:
- Purpose. AB 443 (Salas), Chapter 549, Statutes of 2017 broadened the scope of practice for optometrists by permitting an optometrist to conduct additional procedures on their patients, including administration of immunizations. To obtain an immunization certification, the law requires an optometrist to complete a Centers for Disease Control and Prevention (CDC)-endorsed training program. However, there are no CDC-endorsed programs. In order to allow an optometrist to receive the certification, this bill specifies a training program may be one endorsed by the Accreditation Council for Pharmacy Education. Such programs are currently operational.
- Urgency. This bill asserts an urgency clause is necessary to protect the health and well-being of the public by allowing appropriately trained optometrists to administer immunizations.
Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081
Date of Hearing: June 26, 2018
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Evan Low, Chair
SBPCA Bill Id:SB 762
Author:(Hernandez) – As Amended Ver:June 11, 2018
SENATE VOTE: 40-0
SUBJECT: Optometry: administration of immunizations
SUMMARY: Provides cleanup to the provisions of law authorizing licensed optometrists to administer immunizations by allowing for immunization training programs to be endorsed by either the federal Centers for Disease Control and Prevention (CDC) or the Accreditation Council for Pharmacy Education.
EXISTING LAW:
- Establishes the State Board of Optometry (Board) within the Department of Consumer Affairs for the licensure and regulation of optometrists, registered dispensing opticians, contact lens dispensers, spectacle lens dispensers, and nonresident contact lens dispensers. (Business and Professions Code (BPC) § 3000 et al.)
- Requires the Board to consist of eleven members, five of whom are public members, and one of whom is a registered dispensing optician. (BPC Section 3010.5(a))
- States that protection of the public is the highest priority of the Board in exercising its licensing, regulatory, and disciplinary functions. (BPC Section 3010.1)
- Provides for the certification of optometrists to use therapeutic pharmaceutical agents and the authorization to diagnose and treat disorders and dysfunctions of the visual system, and the treatment and management of certain disorders and dysfunctions of the visual system, as well as the provision of habilitative or rehabilitative optometric services and the administration of immunizations, under certain conditions. (BPC § 3041.)
THIS BILL:
- Allows for the training program required for an optometrist to be certified for the administration of immunizations to be endorsed by the Accreditation Council for Pharmacy Education in addition to the CDC.
- Makes various technical corrections, including the correction of erroneous cross-references.
FISCAL EFFECT: Unknown, as this bill has been substantially amended since it passed the Assembly Committee on Appropriations; the bill is keyed fiscal by the Legislative Counsel.
COMMENTS:
Purpose. This bill is sponsored by the California Optometric Association. According to the author:
The Legislature recently expanded the optometric scope of practice to include administration of three immunizations after taking an immunization training course that is endorsed by the CDC. The problem with this is that no such course exists. California law allows pharmacists to similarly administer immunizations after training from CDC or the Accreditation Council for Pharmacy Education. The Accreditation Council for Pharmacy Education often works with other organizations to craft training programs that they endorse. SB 762 will match the training for optometrists administering immunizations to that required for pharmacists. This will allow optometrists to have appropriate training and practice at the fullest extent that their license allows.
Background. AB 443 (Salas) of 2017 made a number of changes to the Optometry Practice Act including broadening the scope of practice for optometrists by permitting an optometrist to conduct additional procedures on their patients. This includes an optional certification that allows an optometrist to administer immunizations. One requirement for an optometrist to obtain this certification is completion of an immunization training program. Under current law, the program must be endorsed by the CDC; however, it has come to light that no such programs exist at this time. This bill would add programs endorsed by the Accreditation Council for Pharmacy Education, which do exist, so that optometrists may begin receiving the certification.
Current Related Legislation. AB 3184 (Rubio) would change the name of the State Board of Optometry to the California State Board of Optometry.
Prior Related Legislation. AB 443 (Salas) made a number of changes to the Optometry Practice Act including broadening the scope of practice for optometrists by permitting an optometrist to conduct additional procedures on their patients.
AMENDMENTS:
In order to allow optometrists to begin taking the courses necessary to become certified to administer immunizations as soon as possible:
Add an urgency clause to the bill.
REGISTERED SUPPORT:
California Optometric Association (Sponsor)
REGISTERED OPPOSITION:
None on file.
Analysis Prepared by: Robert Sumner / B. & P. / (916) 319-3301
Office of Senate Floor Analyses (916) 651-1520 Fax: (916) 327-4478 | SB |
THIRD READING
Bill No: SB 762
:
SENATE BUS., PROF. & ECON. DEV. COMMITTEE: 9-0, 4/24/17
AYES: Hill, Fuller, Dodd, Galgiani, Glazer, Hernandez, Newman, Pan, Wilk
SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/25/17
AYES: Lara, Bates, Beall, Bradford, Hill, Nielsen, Wiener
DIGEST:
This bill waives
the renewal license fee for inactive licensees under all allied health boards and bureaus for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation that provides medical services to indigent patients in medically underserved or critical-need population areas of the state.
Existing law:
- Provides for the licensing and regulation of various professions and businesses by some 26 boards, 3 committees (20 of which are designated as healing arts boards or committees), 8 bureaus and 1 commission within the Department of Consumer Affairs (DCA) under various licensing acts within the Business and Professions Code (BPC). (For future reference, “board(s)” means all of the above.)
- Provides it is the intent of the Legislature to establish an inactive category of health professionals’ licensure. Such inactive licenses or certificates are intended to allow a person who has a license or certificate in one of the healing arts, but who is not actively engaged in the practice of his or her profession, to maintain licensure or certification in a nonpracticing status. (BPC § 700)
- Requires that each healing arts board issue, upon application and payment of the normal renewal fee, an inactive license or certificate to a current holder of an active license or certificate whose license or certificate is not suspended, revoked, or otherwise punitively restricted by that board. Provides that “board” refers to any healing arts board, division, or examining committee which licenses or certifies health professionals. (BPC § 701)
- Requires that the holder of an inactive healing arts license or certificate issued not engage in any activity for which an active license or certificate is required.
(BPC § 702) - Requires that an inactive healing arts license or certificate issued be renewed during the same time period at which an active license or certificate is renewed. In order to renew a license or certificate, the holder thereof need not comply with any continuing education requirement for renewal of an active license or certificate. Requires that the renewal fee for a license or certificate in an active status apply also for renewal of a license or certificate in an inactive status. (BPC § 703)
- Provides that in order for the holder of an inactive license or certificate issued to restore his or her license or certificate to an active status, the holder of an inactive license or certificate shall comply with all the following: (BPC § 704)
- Pay the renewal fee; provided, that the renewal fee shall be waived for a physician and surgeon who certifies to the Medical Board of California that license restoration is for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation which provides medical services to indigent patients in medically underserved or critical-need population areas of the state.
- If the board requires completion of continuing education for renewers of an active license or certificate, complete continuing education equivalent to that required for a single license renewal period.
- Authorizes certain healthcare boards to allow healthcare practitioners licensed in another state to provide healthcare services in limited circumstances, for a nonprofit organization which sponsors an event through which health care is provided to the public without compensation to the health care practitioner. (BPC § 901)
- Makes findings and declarations stating that: (BPC § 921)
- In times of national or state disasters, a shortage of qualified health care practitioners may exist in areas throughout the state where they are desperately required to respond to public health emergencies.
- Health care practitioners with lapsed or inactive licenses could potentially serve in those areas where a shortage of qualified health care practitioners exists, if licensing requirements were streamlined and fees curtailed.
This bill waives the renewal license fee for inactive licensees under all allied health boards and bureaus for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation that provides medical services to indigent patients in medically underserved or critical-need population areas of the state.
Background
The author is the sponsor of this bill. According to the author, “The coverage expansions under the Affordable Care Act (ACA) led to 20 million newly insured individuals in this country, including over 5 million Californians. While a monumental step towards ensuring access, these expansions came with increased demand for services on an already strained system, particularly in medically underserved areas. Furthermore, fundamental to health care reform is the evolution in how care is delivered. The ACA included incentives for expanded and improved primary care and to create team-based models of service delivery, both of which may affect demand for services from certain health care professionals. Given the shortage of primary care physicians in certain regions and the continued advancements in training of other health care professionals, SB 762 will help ease the strain on the system by providing the opportunity for all health care professionals to deliver volunteer services under their licenses.”
SB 450 (Speier, Chapter 631, Statutes of 1999) originally waived renewal fees for inactive physician licensees for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation that provides medical services to indigent patients in medically underserved or critical-need population areas of the state. The Senate floor analysis, dated September 2, 1999, states:
“Finally, in regard to waiving the physician’s fee for volunteer work, the author provided information about a program that started in South Carolina called the Volunteers in Medicine Institute that used retired physicians to provide care to the needy, and the author suggests that this provision will assist organizations such as this one to operate in California.”
AB 2699 (Bass, Chapter 270, Statutes of 2010) created a pilot program that allowed out-of-state licensed or certified health care practitioners to provide free health care services on a short-term, voluntary basis, and without possessing a California medical license, to uninsured and underinsured individuals in California. The bill also permitted these out-of-state medical professionals to provide these services in the event of a declared state of emergency. The program had a sunset date of January 2014. AB 512 extended the sunset date of this pilot program from January 2014 to January 2018.
FISCAL EFFECT: Appropriation: Fiscal Com.: Local:
According to the Senate Appropriations Committee, this bill has a one-time cost of $360,000 for the DCA to modify the information technology system used by most healing arts boards for licensing (Consumer Affairs Fund). Reduced license renewal fee revenues to various boards and committees that license health care professionals (various funds). The size of the reduction in fee revenue will depend on the number of inactive licensees each board has and the proportion of those inactive licensees who seek to restore an active license to provide unpaid care. For example, based on the current inactive licensee population, and assuming that 10% of those inactive licensees would seek a fee waiver under the bill, revenue losses would be:
- Board of Registered Nursing - $130,000 per year (Registered Nursing Fund).
- Board of Psychology - $120,000 per year (Psychology Fund)
- Dental Board - $100,000 per year (Dental Board Fund)
Revenue losses for the remaining boards are not anticipated to be significant, either because the inactive licensee population is not large or because the board already has a program to waive the renewal fee (such as the Medical Board).
None received
OPPOSITION: (Verified 5/25/17)
None received
5/27/17 15:57:02
**** END ****
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2017 - 2018 Regular Session
SB 762 (Hernandez) - Healing arts licensee: license activation fee: waiver
Version: April 17, 2017 | Policy Vote: B., P. & E.D. 9 - 0 |
Urgency: No | Mandate: No |
Hearing Date: May 15, 2017 | Consultant: Brendan McCarthy |
This bill meets the criteria for referral to the Suspense File.
Bill Summary:
SB 762 would waive the license renewal fee required when a healing arts licensee with an inactive license seeks to restore an active license for the purpose of providing voluntary medical service.
Fiscal Impact:
- One-time cost of $360,000 for the Department of Consumer Affairs to modify the information technology system used by most healing arts boards for licensing (Consumer Affairs Fund).
- Reduced license renewal fee revenues to various boards and committees that license health care professionals (various funds). The size of the reduction in fee revenue will depend on the number of inactive licensees each board has and the proportion of those inactive licensees who seek to restore an active license to provide unpaid care.
For example, based on the current inactive licensee population, and assuming that 10% of those inactive licensees would seek a fee waiver under the bill, revenue losses would be:
- Board of Registered Nursing - $130,000 per year (Registered Nursing Fund).
- Board of Psychology - $120,000 per year (Psychology Fund)
- Dental Board - $100,000 per year (Dental Board Fund)
Revenue losses for the remaining boards are not anticipated to be significant, either because the inactive licensee population is not large or because the board already has a program to waive the renewal fee (such as the Medical Board).
Background:
Under current law, 20 boards and committees within the Department of Consumer Affairs license health care professionals. Current law allows licensed professionals to be issued an inactive license, provided the current license is in good standing and the licensee pays the normal license renewal fee. Holders of an inactive license do not have to meet continuing education requirements, but also cannot practice their profession. The holder of an inactive license can restore the license to an active license, provided that the licensee pays the renewal fee and meets any continuing education requirements for a single license renewal period.
Current law provides that the fee required to restore an inactive license to an active license for a physician is waived if the restoration of an active license is solely to provide voluntary service to medically underserved populations.
Proposed Law:
SB 762 would waive the license renewal fee required when a healing arts licensee with an inactive license seeks to restore an active license for the purpose of providing voluntary medical service.
-- END --
SENATE COMMITTEE ON
BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT
Senator Jerry Hill, Chair
2017 - 2018 Regular
Bill No: SB 762 Hearing Date: April 24, 2017
Author: | Hernandez | ||
Version: |
| ||
Urgency: | Fiscal: | ||
Consultant: | |||
Subject: Healing arts licensee: license activation fee: waiver
SUMMARY: Waives
the renewal license fee for inactive licensees under all allied health boards and bureaus for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation that provides medical services to indigent patients in medically underserved or critical-need population areas of the state.
Existing law:
- Provides for the licensing and regulation of various professions and businesses by some 26 boards, 3 committees (20 of which are designated as healing arts boards or committees), 8 bureaus and 1 commission within the Department of Consumer Affairs (DCA) under various licensing acts within the Business and Professions Code (BPC). (For future reference, “board(s)” means all of the above.)
- Provides it is the intent of the Legislature to establish an inactive category of health professionals’ licensure. Such inactive licenses or certificates are intended to allow a person who has a license or certificate in one of the healing arts, but who is not actively engaged in the practice of his or her profession, to maintain licensure or certification in a nonpracticing status. (BPC § 700)
- Requires that each healing arts board issue, upon application and payment of the normal renewal fee, an inactive license or certificate to a current holder of an active license or certificate whose license or certificate is not suspended, revoked, or otherwise punitively restricted by that board. Provides that “board” refers to any healing arts board, division, or examining committee which licenses or certifies health professionals. (BPC § 701)
- Requires that the holder of an inactive healing arts license or certificate issued not engage in any activity for which an active license or certificate is required.
(BPC § 702) - Requires that an inactive healing arts license or certificate issued be renewed during the same time period at which an active license or certificate is renewed. In order to renew a license or certificate, the holder thereof need not comply with any continuing education requirement for renewal of an active license or certificate. Requires that the renewal fee for a license or certificate in an active status apply also for renewal of a license or certificate in an inactive status. (BPC § 703)
- Provides that in order for the holder of an inactive license or certificate issued to restore his or her license or certificate to an active status, the holder of an inactive license or certificate shall comply with all the following: (BPC § 704)
- Pay the renewal fee; provided, that the renewal fee shall be waived for a physician and surgeon who certifies to the Medical Board of California that license restoration is for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation which provides medical services to indigent patients in medically underserved or critical-need population areas of the state.
- If the board requires completion of continuing education for renewers of an active license or certificate, complete continuing education equivalent to that required for a single license renewal period.
- Authorizes certain healthcare boards to allow healthcare practitioners licensed in another state to provide healthcare services in limited circumstances, for a nonprofit organization which sponsors an event through which health care is provided to the public without compensation to the health care practitioner. (BPC § 901)
- Makes findings and declarations stating that: (BPC § 921)
- In times of national or state disasters, a shortage of qualified health care practitioners may exist in areas throughout the state where they are desperately required to respond to public health emergencies.
- Health care practitioners with lapsed or inactive licenses could potentially serve in those areas where a shortage of qualified health care practitioners exists, if licensing requirements were streamlined and fees curtailed.
This bill: Waives
the renewal license fee for inactive licensees under all allied health boards and bureaus for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation that provides medical services to indigent patients in medically underserved or critical-need population areas of the state.
FISCAL EFFECT: Unknown. This bill is keyed “fiscal” by Legislative Counsel.
COMMENTS:
- Purpose. The Author is the sponsor of this bill. According to the Author, “The coverage expansions under the Affordable Care Act (ACA) led to 20 million newly insured individuals in this country, including over 5 million Californians. While a monumental step towards ensuring access, these expansions came with increased demand for services on an already strained system, particularly in medically underserved areas. Furthermore, fundamental to health care reform is the evolution in how care is delivered. The ACA included incentives for expanded and improved primary care and to create team-based models of service delivery, both of which may affect demand for services from certain health care professionals. Given the shortage of primary care physicians in certain regions and the continued advancements in training of other health care professionals, SB 762 will help ease the strain on the system by providing the opportunity for all health care professionals to deliver volunteer services under their licenses.”
- Background. SB 450 (Speier, Chapter 631, Statutes of 1999) originally waived renewal fees for inactive physician licensees for the sole purpose of providing voluntary, unpaid service to a public agency, not-for-profit agency, institution, or corporation that provides medical services to indigent patients in medically underserved or critical-need population areas of the state. The Senate floor analysis, dated September 2, 1999, states:
“Finally, in regard to waiving the physician’s fee for volunteer work, the author provided information about a program that started in South Carolina called the Volunteers in Medicine Institute that used retired physicians to provide care to the needy, and the author suggests that this provision will assist organizations such as this one to operate in California.”
SUPPORT AND OPPOSITION:
Support:
None on file as of April 19, 2017.
Opposition:
None on file as of April 19, 2017.
-- END --
Discussed in Hearing
47SEC
Senate Floor
2MIN
Senate Standing Committee on Business, Professions and Economic Development
48MIN
Senate Standing Committee on Appropriations
10MIN
Senate Standing Committee on Health
Bill Author
Bill Co-Author(s):