Bill Text: CA SB622 | 2015-2016 | Regular Session | Amended
Bill Title: Optometry.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Failed) 2016-11-30 - From Assembly without further action. [SB622 Detail]
Download: California-2015-SB622-Amended.html
BILL NUMBER: SB 622 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JUNE 22, 2016
AMENDED IN ASSEMBLY JUNE 16, 2016
AMENDED IN SENATE MAY 4, 2015
AMENDED IN SENATE APRIL 9, 2015
INTRODUCED BY Senator Hernandez
FEBRUARY 27, 2015
An act to amend Sections 3041 and 3110 of, to add Sections 3041.4,
3041.5, 3041.6, 3041.7, and 3041.8 to, and to repeal and add
Sections 3041.1, 3041.2, and 3041.3 of, the Business and Professions
Code, relating to optometry, and making an appropriation therefor.
LEGISLATIVE COUNSEL'S DIGEST
SB 622, as amended, Hernandez. Optometry.
The Optometry Practice Act provides for the licensure and
regulation of the practice of optometry by the State Board of
Optometry, and defines the practice of optometry to include, among
other things, 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, and doing
certain things, including, but not limited to, the examination of the
human eyes, the determination of the powers or range of human
vision, and the prescribing of contact and spectacle lenses. Existing
law authorizes an optometrist certified to use therapeutic
pharmaceutical agents to diagnose and treat specified conditions, use
specified pharmaceutical agents, and order specified diagnostic
tests. The act requires optometrists treating or diagnosing eye
disease, as specified, to be held to the same standard of care to
which physicians and surgeons and osteopathic physician and surgeons
are held. The act requires an optometrist, in certain circumstances,
to refer a patient to an ophthalmologist or a physician and surgeon,
including when a patient has been diagnosed with a central corneal
ulcer and the central corneal ulcer has not improved within 48 hours
of the diagnosis. The act makes a violation of any of its provisions
a crime. All moneys collected pursuant to the act, except where
otherwise provided, are deposited in the Optometry Fund and
continuously appropriated to the board to carry out the act.
This bill would revise and recast those provisions. The bill would
delete certain requirements that an optometrist refer a patient to
an ophthalmologist or a physician and surgeon, including when a
patient has been diagnosed with a central corneal ulcer and the
central corneal ulcer has not improved within 48 hours of the
diagnosis. The bill would additionally define the practice of
optometry as the provision of habilitative optometric services, and
would authorize the board to allow optometrists to use nonsurgical
technology to treat any authorized condition under the act. The bill
would additionally authorize an optometrist certified to use
therapeutic pharmaceutical agents to collect blood by skin puncture
or venipuncture, to perform skin tests, as specified, to diagnose
ocular allergies, and to use mechanical lipid extraction of meibomian
glands and nonsurgical techniques. The bill would require the board
to grant an optometrist certified to treat glaucoma a certificate for
the use of specified immunizations if certain conditions are met,
including, among others, that the optometrist is certified in basic
life support. The bill would additionally authorize an optometrist
certified to use therapeutic pharmaceutical agents to, among other
things, be certified to use anterior segment lasers, as specified,
and to be certified to perform specified minor procedures, as
specified, if certain requirements are met.
The bill would require the board to charge a fee of not more than
$150 to cover the reasonable regulatory cost of certifying an
optometrist to use anterior segment lasers, a fee of not more than
$150 to cover the reasonable regulatory cost of certifying an
optometrist to use minor procedures, and a fee of not more than $100
to cover the reasonable regulatory cost of certifying an optometrist
to use immunizations. Because this bill would increase those moneys
deposited in a continuously appropriated fund, it would make an
appropriation.
Existing law establishes the Office of Statewide Health Planning
and Development, which is vested with all the duties, powers,
responsibilities, and jurisdiction of the State Department of Public
Health relating to health planning and research development.
This bill would declare the intent of the Legislature that the
Office of Statewide Health Planning and Development designate a pilot
project to test, demonstrate, and evaluate expanded roles for
optometrists in the performance of management and treatment of
diabetes mellitus, hypertension, and hypercholesterolemia.
Because a violation of the act is a crime, this bill would expand
the scope of an existing crime and would, therefore, result in a
state-mandated local program.
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.
Vote: majority. Appropriation: yes. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 3041 of the Business and Professions Code is
amended to read:
3041. (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) The State Board of Optometry shall, by regulation, establish
educational and examination requirements for licensure to ensure the
competence of optometrists to practice pursuant to this chapter,
except as specified in Section 3041.3 related to the use of anterior
segment lasers and in Section 3041.4 related to minor procedures.
Satisfactory completion of the required educational and examination
requirements shall be a condition for the issuance of an original
optometrist license or required certifications pursuant to this
chapter.
(c) The board may promulgate regulations authorizing optometrists
to use noninvasive, nonsurgical technology to treat a condition
authorized by this chapter. The board shall require a licensee to
take a minimum of four hours of education courses on the new
technology and perform an appropriate number of complete clinical
procedures on live human patients to qualify to use each new
technology authorized by the board pursuant to this subdivision.
SEC. 2. Section 3041.1 of the Business and Professions Code is
repealed.
SEC. 3. Section 3041.1 is added to the Business and Professions
Code, to read:
3041.1. (a) (1) An optometrist who is certified to use
therapeutic pharmaceutical agents pursuant to this section may also
diagnose and treat the human eye or eyes, or any of its or their
appendages, for all of the following conditions:
(A) Through medical treatment, infections of the anterior segment
and adnexa.
(B) Ocular allergies of the anterior segment and adnexa.
(C) Ocular inflammation, nonsurgical in cause except when
comanaged with the treating physician and surgeon, limited to
inflammation resulting from traumatic iritis, peripheral corneal
inflammatory keratitis, episcleritis, and unilateral nonrecurrent
nongranulomatous idiopathic iritis in patients over 18 years of age.
(D) Traumatic or recurrent conjunctival or corneal abrasions and
erosions.
(E) Corneal and conjunctival surface disease and dry eyes disease.
(F) Ocular pain that is nonsurgical in cause, except when
comanaged with the treating physician and surgeon.
(G) Hypotrichosis and blepharitis.
(2) For purposes of this section, "treat" means the use of
therapeutic pharmaceutical agents, as described in subdivision (b),
and the procedures described in subdivision (c).
(3) For purposes of this chapter, "adnexa" means ocular adnexa.
(b) In diagnosing and treating the conditions listed in
subdivision (a), an optometrist certified to use therapeutic
pharmaceutical agents pursuant to this section may use all of the
following therapeutic pharmaceutical agents:
(1) Topical pharmaceutical agents for the purpose of the
examination of the human eye or eyes for any disease or pathological
condition, including, but not limited to, topical miotics.
(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 patient's 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 Section 3041.2.
(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 and hydrocodone with compounds 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 five days,
with a referral to an ophthalmologist if the pain persists.
(c) An optometrist who is certified to use therapeutic
pharmaceutical agents pursuant to this section may also perform all
of the following:
(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
health care provider.
(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 Clinical Laboratory Improvement Amendments of 1988
(CLIA)(42 U.S.C. Sec. 263a; Public Law 100-578) and that is
and designated as waived in paragraph (9)
necessary for the diagnosis of conditions and diseases of the eye or
adnexa, to detect systemic disease with ocular effects, or if
otherwise specifically authorized by this chapter.
(11) Skin test to diagnose ocular allergies. Skin tests shall be
limited to the superficial layer of the skin.
(12) Punctal occlusion by plugs, excluding laser, diathermy,
cryotherapy, or other means constituting surgery as defined in this
chapter.
(13) The prescription of therapeutic contact lenses, diagnostic
contact lenses, or biological or technological corneal devices that
diagnose or treat a condition authorized under this chapter.
(14) 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.
(15) 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 and confirmation of 10
procedures under the supervision of an ophthalmologist or optometrist
who is certified in lacrimal irrigation and dilation. Any
optometrist who graduated from an accredited school of optometry on
or after May 1, 2000, shall be exempt from the certification
requirement contained in this paragraph.
(16) Use of mechanical lipid extraction of meibomian glands and
nonsurgical techniques.
(d) In order to be certified to use therapeutic pharmaceutical
agents and authorized to diagnose and treat the conditions listed in
this section, an optometrist shall apply for a certificate from the
board and meet all requirements imposed by the board.
(e) The board shall grant a certificate to use therapeutic
pharmaceutical agents to any applicant who graduated from a
California accredited school of optometry prior to January 1, 1996,
is licensed as an optometrist in California, and meets all of the
following requirements:
(1) Satisfactorily completes a didactic course of no less than 80
classroom hours in the diagnosis, pharmacological, and other
treatment and management of ocular disease provided by either an
accredited school of optometry in California or a recognized
residency review committee in ophthalmology in California.
(2) Completes a preceptorship of no less than 65 hours, during a
period of not less than two months nor more than one year, in either
an ophthalmologist's office or an optometric clinic. The training
received during the preceptorship shall be on the diagnosis,
treatment, and management of ocular, systemic disease. The preceptor
shall certify completion of the preceptorship. Authorization for the
ophthalmologist to serve as a preceptor shall be provided by an
accredited school of optometry in California, or by a recognized
residency review committee in ophthalmology, and the preceptor shall
be licensed as an ophthalmologist in California, board certified in
ophthalmology, and in good standing with the Medical Board of
California. The individual serving as the preceptor shall schedule no
more than three optometrist applicants for each of the required 65
hours of the preceptorship program. This paragraph shall not be
construed to limit the total number of optometrist applicants for
whom an individual may serve as a preceptor, and is intended only to
ensure the quality of the preceptorship by requiring that the
ophthalmologist preceptor schedule the training so that each
applicant optometrist completes each of the 65 hours of the
preceptorship while scheduled with no more than two other optometrist
applicants.
(3) Successfully completes a minimum of 20 hours of self-directed
education.
(4) Passes the National Board of Examiners in Optometry's
"Treatment and Management of Ocular Disease" examination or, in the
event this examination is no longer offered, its equivalent, as
determined by the State Board of Optometry.
(5) Passes the examination issued upon completion of the 80-hour
didactic course required under paragraph (1) and provided by the
accredited school of optometry or residency program in ophthalmology.
(6) When any or all of the requirements contained in paragraph
(1), (4), or (5) have been satisfied on or after July 1, 1992, and
before January 1, 1996, an optometrist shall not be required to
fulfill the satisfied requirements in order to obtain certification
to use therapeutic pharmaceutical agents. In order for this paragraph
to apply to the requirement contained in paragraph (5), the didactic
examination that the applicant successfully completed shall meet
equivalency standards, as determined by the board.
(7) Any optometrist who graduated from an accredited school of
optometry on or after January 1, 1992, and before January 1, 1996,
shall not be required to fulfill the requirements contained in
paragraphs (1), (4), and (5).
(f) The board shall grant a certificate to use therapeutic
pharmaceutical agents to any applicant who graduated from a
California accredited school of optometry on or after January 1,
1996, who is licensed as an optometrist in California, and who meets
all of the following requirements:
(1) Passes the National Board of Examiners in Optometry's national
board examination, or its equivalent, as determined by the State
Board of Optometry.
(2) Of the total clinical training required by a school of
optometry's curriculum, successfully completed at least 65 of those
hours on the diagnosis, treatment, and management of ocular, systemic
disease.
(3) Is certified by an accredited school of optometry as competent
in the diagnosis, treatment, and management of ocular, systemic
disease to the extent authorized by this section.
(4) Is certified by an accredited school of optometry as having
completed at least 10 hours of experience with a board-certified
ophthalmologist.
(g) The board shall grant a certificate to use therapeutic
pharmaceutical agents to any applicant who is an optometrist who
obtained his or her license outside of California if he or she meets
all of the requirements for an optometrist licensed in California to
be certified to use therapeutic pharmaceutical agents.
(1) In order to obtain a certificate to use therapeutic
pharmaceutical agents, any optometrist who obtained his or her
license outside of California and graduated from an accredited school
of optometry prior to January 1, 1996, shall be required to fulfill
the requirements set forth in subdivision (e). In order for the
applicant to be eligible for the certificate to use therapeutic
pharmaceutical agents, the education he or she received at the
accredited out-of-state school of optometry shall be equivalent to
the education provided by any accredited school of optometry in
California for persons who graduated before January 1, 1996. For
those out-of-state applicants who request that any of the
requirements contained in subdivision (e) be waived based on
fulfillment of the requirement in another state, if the board
determines that the completed requirement was equivalent to that
required in California, the requirement shall be waived.
(2) In order to obtain a certificate to use therapeutic
pharmaceutical agents, any optometrist who obtained his or her
license outside of California and who graduated from an accredited
school of optometry on or after January 1, 1996, shall be required to
fulfill the requirements set forth in subdivision (f). In order for
the applicant to be eligible for the certificate to use therapeutic
pharmaceutical agents, the education he or she received by the
accredited out-of-state school of optometry shall be equivalent to
the education provided by any accredited school of optometry for
persons who graduated on or after January 1, 1996. For those
out-of-state applicants who request that any of the requirements
contained in subdivision (f) be waived based on fulfillment of the
requirement in another state, if the board determines that the
completed requirement was equivalent to that required in California,
the requirement shall be waived.
(3) The State Board of Optometry shall decide all issues relating
to the equivalency of an optometrist's education or training under
this subdivision.
(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) Except as authorized by this chapter, 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 subdivision (c). This section does not
limit an optometrist's authority to utilize diagnostic laser and
ultrasound technology within his or her scope of practice.
(j) 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. 4. Section 3041.2 of the Business and Professions Code is
repealed.
SEC. 5. Section 3041.2 is added to the Business and Professions
Code, to read:
3041.2. (a) For purposes of this chapter, "glaucoma" means any of
the following:
(1) All primary open-angle glaucoma.
(2) Exfoliation and pigmentary glaucoma.
(3) Increase in intraocular pressure caused by steroid medication
prescribed by the optometrist.
(4) Increase in intraocular pressure caused by steroid medication
not prescribed by the optometrist, after consultation and treatment
approval by the prescribing physician.
(b) An optometrist certified pursuant to Section 3041.1 shall be
certified for the treatment of glaucoma, as described in subdivision
(a), 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 are not described in
paragraph (2) or (3), submission of proof of satisfactory completion
of the requirements for certification established by the board.
SEC. 6. Section 3041.3 of the Business and Professions Code is
repealed.
SEC. 7. Section 3041.3 is added to the Business and Professions
Code, to read:
3041.3. (a) For the purposes of this chapter, "anterior segment
laser" means any of the following:
(1) Therapeutic lasers appropriate for treatment of glaucoma.
(2) Notwithstanding subdivision (a) of Section 3041.2, peripheral
iridotomy for the prophylactic treatment of angle closure glaucoma.
(3) Therapeutic lasers used for posterior capsulotomy secondary to
cataract surgery.
(b) An optometrist certified to treat glaucoma pursuant to Section
3041.2 shall be additionally certified for the use of anterior
segment lasers after submitting proof of satisfactory completion of a
course that is approved by the board, provided by an accredited
school of optometry, and developed in consultation with an
ophthalmologist who has experience educating optometric students. The
board shall issue a certificate pursuant to this section only to an
optometrist that has graduated from an approved school of optometry.
(1) The board-approved course shall be at least 25 hours in
length, and include a test for competency of the following:
(A) Laser physics, hazards, and safety.
(B) Biophysics of laser.
(C) Laser application in clinical optometry.
(D) Laser tissue interactions.
(E) Laser indications, contraindications, and potential
complications.
(F) Gonioscopy.
(G) Laser therapy for open-angle glaucoma.
(H) Laser therapy for angle closure glaucoma.
(I) Posterior capsulotomy.
(J) Common complications of the lids, lashes, and lacrimal system.
(K) Medicolegal aspects of anterior segment procedures.
(L) Peripheral iridotomy.
(M) Laser trabeculoplasty.
(2) The school of optometry shall require each applicant for
certification to perform a sufficient number of complete anterior
segment laser procedures to verify that the applicant has
demonstrated competency to practice independently. At a minimum, each
applicant shall complete 24 anterior segment laser procedures on
live humans as follows:
(A) Eight YAG capsulotomy procedures.
(B) Eight laser trabeculoplasty procedures.
(C) Eight peripheral iridotomy procedures.
(c) The board, by regulation, shall set the fee for issuance and
renewal of a certificate authorizing the use of anterior segment
lasers at an amount no higher than the reasonable cost of regulating
anterior segment laser certified optometrists pursuant to this
section. The fee shall not exceed one hundred fifty dollars ($150).
(d) An optometrist certified to use anterior segment lasers
pursuant to this section shall complete four hours of continuing
education on anterior segment lasers as part of the required 50 hours
of continuing education required to be completed every two years on
the diagnosis, treatment, and management of glaucoma.
SEC. 8. Section 3041.4 is added to the Business and Professions
Code, to read:
3041.4. (a) For the purposes of this chapter, "minor procedure"
means either of the following:
(1) Removal, destruction, or drainage of lesions of the eyelid and
adnexa clinically evaluated by the optometrist to be noncancerous,
not involving the eyelid margin, lacrimal supply or drainage systems,
no deeper than the orbicularis muscle, and smaller than five
millimeters in diameter.
(2) Closure of a wound resulting from a procedure described in
paragraph (1).
(3) Administration of injections for the diagnoses or treatment of
conditions of the eye and adnexa authorized by this chapter,
excluding intraorbital injections and injections administered for
cosmetic effect.
(4) "Minor procedures" 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 Section
3041.2 shall be additionally certified to perform minor procedures
after submitting proof of satisfactory completion of a course that is
approved by the board, provided by an accredited school of
optometry, and developed in consultation with an ophthalmologist who
has experience teaching optometric students. The board shall issue a
certificate pursuant to this section only to an optometrist that has
graduated from an approved school of optometry.
(1) The board-approved course shall be at least 25 hours in length
and include a test for competency of the following:
(A) Minor surgical procedures.
(B) Overview of surgical instruments, asepsis, and the state and
federal Occupational Safety and Health Administrations.
(C) Surgical anatomy of the eyelids.
(D) Emergency surgical procedures.
(E) Chalazion management.
(F) Epiluminescence microscopy.
(G) Suture techniques.
(H) Local anesthesia techniques and complications.
(I) Anaphylaxsis and other office emergencies.
(J) Radiofrequency surgery.
(K) Postoperative wound care.
(L) Injection techniques.
(2) The school of optometry shall require each applicant for
certification to perform a sufficient number of minor procedures to
verify that the applicant has demonstrated competency to practice
independently. At a minimum, each applicant shall perform 32 complete
minor procedures on live humans.
(c) The board, by regulation, shall set the fee for issuance and
renewal of a certificate authorizing the use of minor procedures at
an amount no greater than the reasonable cost of regulating minor
procedure certified optometrists pursuant to this section. The fee
shall not exceed one hundred fifty dollars ($150).
(d) An optometrist certified to perform minor procedures pursuant
to Section 3041.1 shall complete five hours of continuing education
on the diagnosis, treatment, and management of lesions of the eyelid
and adnexa as part of the 50 hours of continuing education required
every two years in Section 3059.
SEC. 9. Section 3041.5 is added to the Business and Professions
Code, to read:
3041.5. (a) The board shall grant to an optometrist a certificate
for the use of immunizations described in subdivision (b), if the
optometrist is certified pursuant to Section 3041.2 and after the
optometrist meets all of the following requirements:
(1) 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.
(2) Is certified in basic life support.
(3) Complies with all state and federal recordkeeping and
reporting requirements, including providing documentation to the
patient's primary care provider and entering information in the
appropriate immunization registry designated by the immunization
branch of the State Department of Public Health.
(b) 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.
(c) The board, by regulation, shall set the fee for issuance and
renewal of a certificate for the use of immunizations at the
reasonable cost of regulating immunization certified optometrists
pursuant to this section. The fee shall not exceed one hundred
dollars ($100).
SEC. 10. Section 3041.6 is added to the Business and Professions
Code, to read:
3041.6. An optometrist licensed under this chapter is subject to
the provisions of Section 2290.5 for purposes of practicing
telehealth.
SEC. 11. Section 3041.7 is added to the Business and Professions
Code, to read:
3041.7. Optometrists diagnosing or treating eye disease shall be
held to the same standard of care to which physicians and surgeons
and osteopathic physicians and surgeons are held. An optometrist
shall consult with and, if necessary, refer to a physician and
surgeon or other appropriate health care provider when a situation or
condition occurs that is beyond the optometrist's scope of practice.
SEC. 12. Section 3041.8 is added to the Business and Professions
Code, to read:
3041.8. It is the intent of the Legislature that the Office of
Statewide Health Planning and Development, under the Health Workforce
Pilot Projects Program, designate a pilot project to test,
demonstrate, and evaluate expanded roles for optometrists in the
performance of management and treatment of diabetes mellitus,
hypertension, and hypercholesterolemia.
SEC. 13. Section 3110 of the Business and Professions Code is
amended to read:
3110. The board may take action against any licensee
who is charged with unprofessional conduct, and may deny an
application for a license if the applicant has committed
unprofessional conduct. In addition to other provisions of this
article, unprofessional conduct includes, but is not limited to, the
following:
(a) Violating or attempting to violate, directly or indirectly
assisting in or abetting the violation of, or conspiring to violate
any provision of this chapter or any of the rules and regulations
adopted by the board pursuant to this chapter.
(b) Gross negligence.
(c) Repeated negligent acts. To be repeated, there must be two or
more negligent acts or omissions.
(d) Incompetence.
(e) The commission of fraud, misrepresentation, or any act
involving dishonesty or corruption, that is substantially related to
the qualifications, functions, or duties of an optometrist.
(f) Any action or conduct that would have warranted the denial of
a license.
(g) The use of advertising relating to optometry that violates
Section 651 or 17500.
(h) Denial of licensure, revocation, suspension, restriction, or
any other disciplinary action against a health care professional
license by another state or territory of the United States, by any
other governmental agency, or by another California health care
professional licensing board. A certified copy of the decision or
judgment shall be conclusive evidence of that action.
(i) Procuring his or her license by fraud, misrepresentation, or
mistake.
(j) Making or giving any false statement or information in
connection with the application for issuance of a license.
(k) Conviction of a felony or of any offense substantially related
to the qualifications, functions, and duties of an optometrist, in
which event the record of the conviction shall be conclusive evidence
thereof.
(l) Administering to himself or herself any controlled substance
or using any of the dangerous drugs specified in Section 4022, or
using alcoholic beverages to the extent, or in a manner, as to be
dangerous or injurious to the person applying for a license or
holding a license under this chapter, or to any other person, or to
the public, or, to the extent that the use impairs the ability of the
person applying for or holding a license to conduct with safety to
the public the practice authorized by the license, or the conviction
of a misdemeanor or felony involving the use, consumption, or
self-administration of any of the substances referred to in this
subdivision, or any combination thereof.
(m) (1) Committing or soliciting an act punishable as a sexually
related crime, if that act or solicitation is substantially related
to the qualifications, functions, or duties of an optometrist.
(2) Committing any act of sexual abuse, misconduct, or relations
with a patient. The commission of and conviction for any act of
sexual abuse, sexual misconduct, or attempted sexual misconduct,
whether or not with a patient, shall be considered a crime
substantially related to the qualifications, functions, or duties of
a licensee. This paragraph shall not apply to sexual contact between
any person licensed under this chapter and his or her spouse or
person in an equivalent domestic relationship when that licensee
provides optometry treatment to his or her spouse or person in an
equivalent domestic relationship.
(3) Conviction of a crime that requires the person to register as
a sex offender pursuant to Chapter 5.5 (commencing with Section 290)
of Title 9 of Part 1 of the Penal Code. A conviction within the
meaning of this paragraph means a plea or verdict of guilty or a
conviction following a plea of nolo contendere. A conviction
described in this paragraph shall be considered a crime substantially
related to the qualifications, functions, or duties of a licensee.
(n) Repeated acts of excessive prescribing, furnishing, or
administering of controlled substances or dangerous drugs specified
in Section 4022, or repeated acts of excessive treatment.
(o) Repeated acts of excessive use of diagnostic or therapeutic
procedures, or repeated acts of excessive use of diagnostic or
treatment facilities.
(p) The prescribing, furnishing, or administering of controlled
substances or drugs specified in Section 4022, or treatment without a
good faith prior examination of the patient and optometric reason.
(q) The failure to maintain adequate and accurate records relating
to the provision of services to his or her patients.
(r) Performing, or holding oneself out as being able to perform,
or offering to perform, any professional services beyond the scope of
the license authorized by this chapter.
(s) The practice of optometry without a valid, unrevoked,
unexpired license.
(t) The employing, directly or indirectly, of any suspended or
unlicensed optometrist to perform any work for which an optometry
license is required.
(u) Permitting another person to use the licensee's optometry
license for any purpose.
(v) Altering with fraudulent intent a license issued by the board,
or using a fraudulently altered license, permit certification or any
registration issued by the board.
(w) Except for good cause, the knowing failure to protect patients
by failing to follow infection control guidelines of the board,
thereby risking transmission of bloodborne infectious diseases from
optometrist to patient, from patient to patient, or from patient to
optometrist. In administering this subdivision, the board shall
consider the standards, regulations, and guidelines of the State
Department of Public Health developed pursuant to Section 1250.11 of
the Health and Safety Code and the standards, guidelines, and
regulations pursuant to the California Occupational Safety and Health
Act of 1973 (Part 1 (commencing with Section 6300) of Division 5 of
the Labor Code) for preventing the transmission of HIV, hepatitis B,
and other bloodborne pathogens in health care settings. As necessary,
the board may consult with the Medical Board of California, the
California Board of Podiatric Medicine, the Board of Registered
Nursing, and the Board of Vocational Nursing and Psychiatric
Technicians of the State of California, to encourage appropriate
consistency in the implementation of this subdivision.
(x) Failure or refusal to comply with a request for the clinical
records of a patient, that is accompanied by that patient's written
authorization for release of records to the board, within 15 days of
receiving the request and authorization, unless the licensee is
unable to provide the documents within this time period for good
cause.
(y) Failure to refer a patient to an appropriate physician if an
examination of the eyes indicates a substantial likelihood of any
pathology that requires the attention of that physician.
SEC. 14. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.
