CAEPS closely follows bills moving through the California Legislature of interest to Ophthalmology and the field of Medicine in general. Of interest currently are the following bills:
AB 890, (Wood) has passed both the Assembly and Senate. If signed by the Governor, it would grant independent practice authority to nurse practitioners (NPs). Governor Newsom has until September 30th to sign or veto the bill.
CAEPS and the California Medical Association (CMA) are concerned that the bill lacks sufficient training requirements and safeguards for independent practice, and will do little or nothing to expand access to care-- a primary focus of the bill's supporters.
Furthermore, the bill will likely raise the costs of care. Credible studies indicate that NPs will order more imaging services, tests, and pharmaceuticals, further burdening the Medi-Cal program, and therefore the state's already tenuous budget given the COVID-19 pandemic.
AB 1467 (Salas) was a "spot" (placeholder) bill that was intended to ultimately contain any agreed upon terms of changes to the Optometric Practice Act that might result from ongoing discussions between CAEPS, the California Medical Association (CMA), and the California Optometric Association (COA). The bill's author and the involved stakeholders have agreed that the bill will only contain items agreed to by all parties.
Of specific interest to the COA is the ability of optometrists to perform laser surgical procedures for glaucoma and posterior capsule opacity, scalpel surgical removal and other treatment of eye lesions, and various types of injections (including intravitreal) related to these surgical procedures and the treatment of diseases an optometrist is (or could be) authorized to treat.
While essentially a "shell," the bill references the concept of a "Delegated Services Agreement" under which an optometrist could perform the above-referenced procedures (and others) in conjunction with a physician and surgeon. However, conversations about this concept have exposed many technical issues that make it unlikely to be workable. This realization has redirected the conversation to appropriate substantial training for any new privileges.
CAEPS will continue to work with the CMA and the American Academy of Ophthalmology to prevent the granting of surgical procedures without appropriate training and clinical experience.