Bill Text: CA AB2236 | 2021-2022 | Regular Session | Amended
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Optometry: certification to perform advanced procedures.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Vetoed) 2022-09-28 - Vetoed by Governor. [AB2236 Detail]
Download: California-2021-AB2236-Amended.html
Bill Title: Optometry: certification to perform advanced procedures.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Vetoed) 2022-09-28 - Vetoed by Governor. [AB2236 Detail]
Download: California-2021-AB2236-Amended.html
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Amended
IN
Senate
June 22, 2022 |
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Amended
IN
Assembly
March 17, 2022 |
CALIFORNIA LEGISLATURE—
2021–2022 REGULAR SESSION
Assembly Bill
No. 2236
| Introduced by Assembly Member Low |
February 16, 2022 |
An act to amend Sections 2544 and 3041 of add Section 3041.4 to the Business and Professions Code, relating to healing arts.
LEGISLATIVE COUNSEL'S DIGEST
AB 2236, as amended, Low.
Optometry. Optometry: certification: use of anterior segment lasers and performing minor procedures.
(1)Existing law prohibits any person, other than a physician and surgeon or optometrist, from measuring the powers or range of human vision or determining the accommodative and refractive status of the human eye or the scope of its functions in general or prescribing ophthalmic devices. Existing law authorizes an optometric assistant to perform certain procedures under the responsibility and supervision of specified licensed practitioners, as prescribed.
Existing law requires an optometric assistant in any setting where optometry or ophthalmology is practiced to have at least 45 hours of training in subjective refraction procedures acceptable to the supervising ophthalmologist or optometrist.
This bill would additionally require that training to include the performance of preliminary subjective refraction procedures, as defined.
(2)Existing
Existing law, the Optometry Practice Act, establishes the State Board of Optometry in the Department of Consumer Affairs for the licensure and regulation of the practice of optometry. Existing law sets forth the scope of practice for optometry, including the practices an optometrist certified under certain provisions of existing law may engage in, and specifies exceptions or limitations to that practice. Existing law makes a violation of the provisions of the act a misdemeanor. Existing law requires an optometrist to obtain a therapeutic pharmaceutical agents certification from the board to diagnose and treat certain
conditions, and provides that an optometrist who holds a therapeutic pharmaceutical agents certification is certified to medically treat glaucomas, subject to satisfaction of specified requirements.
Existing law includes in the
practice of optometry, among other things, the diagnosis, prevention, treatment, and management of disorders and dysfunctions of the visual system, including the provision of habilitative or rehabilitative optometric services.
This bill would additionally require any optometrist diagnosing or suspecting angle closure glaucoma in a patient to attempt medical stabilization, if possible, and to immediately refer that patient to an ophthalmologist. authorize an optometrist certified to treat glaucoma to use anterior segment lasers and to perform minor procedures, as defined, if the optometrist obtains an additional certification for those purposes from the board, and would set forth education, training, examination, and other requirements for obtaining that certification. The bill would
require the board to set a fee, not to exceed $150, for the issuance and renewal of the certificate, and would require an optometrist who performs procedures pursuant to these provisions to annually report certain information to the board, including any adverse treatment outcomes associated with the procedure that required a referral to an ophthalmologist. The bill would require the board to report the information to the Governor and the Secretary of Health and Human Services and to make the report available on the board’s internet website, and would authorize the board to adopt regulations to implement the bill’s provisions. By expanding the scope of a crime under the Optometry Practice Act, the bill would impose a state-mandated local program.
(3)The
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YESBill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 3041.4 is added to the Business and Professions Code, to read:3041.4.
(a) For purposes of this section, the following shall apply:(1) “Anterior segment laser” means any of the following:
(A) Therapeutic lasers appropriate for treatment of glaucoma.
(B) Peripheral iridotomy for the prophylactic treatment of angle closure glaucoma.
(C) Therapeutic lasers used for posterior capsulotomy secondary to cataract surgery.
(2) (A) “Minor procedure” means any of the following:
(i) Removal, destruction, or drainage of lesions of the adnexa clinically evaluated by the optometrist to be noncancerous, not involving the eyelid margin, lacrimal supply, or drainage systems, no deeper than the orbicularis muscle, and smaller than five millimeters in diameter.
(ii) Closure of a wound resulting from a procedure described in clause (i).
(iii) Subcutaneous, intramuscular, subconjunctival, and intralesional injections for the diagnosis or treatment of conditions of the eye and adnexa authorized by this chapter.
(B) “Minor procedure” does not include blepharoplasty or other cosmetic surgery procedures that reshape normal structures of the body in order to improve appearance and self-esteem.
(b) An optometrist certified to
treat glaucoma pursuant to subdivision (c) of Section 3041 may use anterior segment lasers and may preform minor procedures if the optometrist is additionally certified pursuant to this section. To apply for certification, an optometrist shall meet all the following requirements:
(1) The optometrist shall complete a board-approved course that is at least 16 hours in length and includes education and testing for competency on specific subjects regarding the use of anterior segment lasers, including placement of the laser, focus of the laser, and application of the laser, and on minor procedures, including, but not limited to, suturing, eyelid surgery, injections, anesthesia, and chalazion excision, as well as medical decisionmaking. The course shall include hands-on instruction on no less than 15 simulated eyes to learn surgical skills, a practical assessment of the optometrist’s technique, and a written examination.
(2) The optometrist shall pass the National Board of Examiners in Optometry’s “Laser and Surgical Procedures Examination,” or, in the event this examination is no longer offered, its equivalent, as determined by the board.
(3) The optometrist shall complete a clinical rotation training by an accredited school of optometry that relates to the use of both anterior segment lasers and minor procedures. This training shall require a cohort of optometrists to independently assess each patient, develop a treatment plan, evaluate the clinical outcome post-treatment, and address adverse or unintended clinical outcomes. The cohort shall discuss and defend their medical decisionmaking for each patient and shall include direct experience with as many live human patients as needed to ensure competency. The training shall include the performance of at least_____ procedures of each type of laser
procedure on live humans, and shall include the performance of at least_____chalazion and __ other type of lesion procedures authorized by this section on live humans.
(c) The board, by regulation, shall set the fee for issuance and renewal of a certificate authorizing the use of anterior segment lasers and performance of minor procedures at an amount no higher than the reasonable cost of regulating anterior segment laser and minor procedure certified optometrists pursuant to this section. The fee shall not exceed one hundred fifty dollars ($150).
(d) An optometrist certified to use anterior segment lasers and perform minor procedures pursuant to this section shall complete 5 hours of continuing education on anterior segment lasers and the diagnosis, treatment, and management of lesions of the adnexa as part of the 50 hours of continuing education required every two years pursuant
to Section 3059.
(e) An optometrist who removes a lesion pursuant to a minor procedure performed pursuant to this section shall have the lesion biopsied. If, during a minor procedure, a lesion is determined to be outside of the parameters described in clause (i) of subparagraph (A) of paragraph (2) of subdivision (a), the optometrist shall stabilize the patient to the greatest extent possible and refer the patient to an appropriate medical professional.
(f) (1) An optometrist who performs a procedure using an anterior segment laser or performs a minor procedure shall monitor and report all of the following information to the board on a yearly basis:
(A) The number and type of anterior segment laser procedures and minor procedures performed.
(B) The diagnosis of the patient at the time the procedure was performed.
(C) Any adverse treatment outcomes associated with the anterior segment laser procedure or minor procedure that required a referral to an ophthalmologist.
(2) The board shall report this information to the Governor and the Secretary of Health and Human Services and shall make the report available on the board’s internet website.
(g) An optometrist certified pursuant to this section shall comply with the reporting requirements set forth by the board with respect to unprofessional conduct, malpractice settlements and judgments, criminal charges and convictions, and any disciplinary action taken by another licensing entity or authority of this state or of another state or an agency of the federal government or the Armed Forces of the
United States that is related to the practice of optometry.
(h) The board may adopt rules and regulations to implement this section.
