Earlier this month, California legislators removed a bill for the 2024 session that supported an increase in the scope of practice for optometrists’ (ODs’) to perform advanced procedures for glaucoma—among other capabilities—without a clear reason as to why.
Set the stage for me.
First things first: California employs the largest number of practicing ODs in the United States, with nearly 7,000 in practice across the state.
Now some legislative background.
Back in 2022, California legislators introduced Assembly Bill (AB) 2236, an expanded scope of practice bill that would have allowed optometrists to use therapeutic lasers, remove lesions, and perform corneal crosslinking, among other advanced surgical procedures.
While the bill was narrowly passed by the California legislature, it was ultimately vetoed in September 2022 when it reached the governor’s desk—with Gov. Gavin Newsom reasoning that, “This bill would allow optometrists to perform advanced surgical procedures with less than 1 year of training. In comparison, physicians who perform these procedures must complete at least a 3-year residency program.”
Following this, in February 2023, identical new legislation was introduced in the state legislation: AB 1570.
Give me the rundown on this bill.
Sponsored by Rep. Evan Low (D) (who also sponsored AB 2236) and known as an expanded scope of practice bill, AB 1570 would have required California-practicing ODs to become certified in order to perform advanced procedures such as:
- Glaucoma laser procedures: selective laser trabeculoplasty and peripheral iridotomy
- Posterior capsulotomy to remedy lens opacification following cataract surgery
- Lesion removal, including skin tags, cysts and other non-cancerous growths
- Injections to treat various eye conditions: subcutaneous, intramuscular, subconjunctival and intralesional
- Corneal collagen cross-linking (CXL) to treat ectatic corneal disease
See here for a summarized version of additional inclusion details.
So what happened this time around?
Following the bill passing the California Assembly Business and Professions Committee earlier this month, AB 1570 was later “held on submission” by the state’s Assembly Appropriations Committee Suspense File.
Translation?
This means there was no vote or official reason provided, according to Kristine Shultz, executive director of the California Optometric Association (COA).
In a message sent to COA members on Jan. 18, Shultz expressed COA’s disappointment in the legislature while also commending the ODs who testified in-person to support the bill during the Committee on Business and Professions Jan. 9 hearing for the bill.
What opposition was there?
Of notable opposition to AB 1570 was the California Medical Association, who wrote that, “This bill would expand the scope of practice for optometrists to perform advanced surgical and laser procedures with minimal training…[and] would put patients at harm…”
How significant was this legislation?
According to COA President Candi Kimura, OD, AB 1570 was key in addressing the ongoing shortage of physicians across the United States that’s expected to only get worse.
Case in point: a 12% decline in the ophthalmology workforce is expected by 2035, according to a new study published in Ophthalmology.
Coupled with a projected 24% increase in total demand for ophthalmologists—along with the need for more trained and qualified physicians—this could be considered a critical signal with patient care and access implications.“
Currently, patients may have to wait months to see an ophthalmologist for procedures that optometrists are trained to provide and have safely performed in other states for decades,” Dr. Kimura told Glance. “Allowing skilled and highly educated doctors of optometry to perform these procedures will result in shorter wait times, lower costs and open the doors to better eye health for patients.”
Any plans for similar legislation in the future?
The COA plans to continue its legislative fight for patients’ rights for quality eye care from their local ODs, according to Dr. Kimura.
“We will introduce a bill in the future with a new training framework that addresses concerns raised by the Legislature and the governor,” she said.
Sounds like a grassroots advocacy effort is ramping up…
For California-practicing ODs, Dr. Kimura recommends meeting with local lawmakers to emphasize the need for such legislation.
“Our message is simple,” she said. “Optometrists already provide the vast majority of eye care under Medi-Cal, are located in almost every county in California, and are trusted providers for patients of diverse backgrounds.”
For California ODs, click here to look up your local representative.
Lastly… what other similar legislation is in the works?
Most notably:
- Nebraska (LB 216)
- New Jersey (A-920 and S-354)
- Ohio (SB 129)
- Vermont (S.233)
- West Virginia (HB 4783) (S.233)
And see here for a glimpse of our coverage on the latest news from the optometric legislation front.
*Disclaimer: The information provided in this article does not and is not intended to constitute legal advice; instead, all information, content, materials available herein are for general information purposes only.