Scope of Practice Bill Sent to Senate Floor

Optometrists could perform more medical duties than currently allowed in California under legislation passed on Monday by the Senate Appropriations Committee.

SB 622 by Sen. Ed Hernandez (D-West Covina), who also is a practicing optometrist, now heads to a Senate floor vote.

The bill is designed to help address the dearth of primary care providers in California by allowing some of their duties to be taken up by optometrists who undergo special training for the tasks. Those include:

  • Post-cataract surgery laser procedures for glaucoma patients;
  • Eyelid lesion removal; and
  • Vaccinations for adults.

“This is especially important for people with glaucoma,” Hernandez said. “Right now optometrists are only able to treat [it] with medication, and some people need more treatment than the medication.”

It’s becoming more important for Medi-Cal patients, as well, with roughly one-third of the state’s population in the program, Hernandez said. Access to specialists and primary care providers is only going to get more difficult, since so few providers take Medi-Cal anymore, he said.

Also, optometrists (along with dentists) often find themselves as the first providers for some people, Hernandez said, so it’s important that they’re able to use the expertise they’ve developed to help those patients.

“The typical situation, this happens all the time, is someone will come in because they couldn’t pass the driver’s license exam, they need glasses so they come in, and the optometrist sees they have diabetic retinopathy.”

The proposal is similar to last session’s SB 492, which also was carried by Hernandez. It is opposed by the California Medical Association and by the Medical Board of California.

A similar bill (SB 323) authored by Hernandez to expand scope of practice for nurse practitioners already passed the Senate and is headed to the Assembly. 

Last session Hernandez managed to pass a scope of practice bill for pharmacists, but failed on bills for nurse practitioners and optometrists. He said ‘s been working on this type of legislation for years, dating back to his time in the Assembly.

“There was a severe provider shortage when we first started on this issue, and it’s just gotten worse.” Hernandez said. “In the medical community, it’s all about control.”

SB 492 passed Senate Appropriations on a unanimous 7-0 vote. It should reach a floor vote early next week, Hernandez said.

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