October 13, 2021
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New California laws expand scope, allow ODs to administer COVID-19 tests, vaccines

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California Governor Gavin Newsom signed into law two bills that will expand optometrists’ scope of practice in the state.

AB 691, introduced by assembly member Ed Chau (D–Monterey Park), authorizes optometrists to administer COVID-19 vaccines permanently and perform CLIA-waived COVID-19 testing, according to a California Optometric Association (CAO) press release.

AB 407, introduced by assembly members Rudy Salas (D-Bakersfield) and Evan Low (D-Silicon Valley), eliminates the restrictive list of allowed drugs and conditions and instead authorizes treatment of all noncancerous anterior segment conditions, with some limitations, the CAO said.

New rules for optometric and medical assistants were also established, including a prohibition of subjective refraction being done by assistants via telemedicine.

AB 691 takes effect immediately; AB 407 takes effect Jan. 1, 2022, the group said.

“These two new laws will help bridge the huge gap between the number of available doctors and the growing number of patients in need,” COA President Ida Chung, OD, said in the release.

According to the COA’s summary of AB 407, some conditions that can now be treated with medication include ametropia, presbyopia and ptosis.

AB 407 allows for the treatment of all types of inflammation in adults and treatment with all antivirals and antifungals, according to the summary. It eliminates duration restrictions on the use of antiallergy agents and restrictions on treating dacryocystitis and canaliculitis.

The legislation allows optometrists to order more tests and CLIA-waived testing to rule out any conditions, including systemic. Further, it removes the restriction on the use of a scalpel to remove a foreign body and allows the administration of intense pulsed light therapy, low-level light therapy, intranasal stimulator and intracanalicular stents, according to the COA’s summary.

“There will be a new medication on the market soon that optometrists will be allowed to use to do ‘medication only’ corneal cross-linking,” the group said in its summary.

The new law allows assistants to perform subjective refraction procedures but not write prescriptions.

“We included this in AB 407 to better regulate what medical assistants are doing, especially in some retail clinics,” the COA said in its summary of the legislation.

The group also specified that, “Performing surgery is excluded from the practice of optometry ... ‘Surgery’ means any act in which the human tissue is cut, altered or otherwise infiltrated by any means.”

The COA noted that it plans to seek future legislation that would expand the types of immunizations that certified optometrists can administer and also grant authority for optometrists to use lasers, remove lesions and perform injections.

The COA stated in the press release that earlier this year, AB 1534 was signed into law, prohibiting retail companies from interfering in an optometrist’s professional judgment. Also passed was SB 509, which allows optometry school graduates to temporarily practice under supervision if they are unable to take Part 3 of the National Board of Examiners in Optometry because of COVID-19. This law took effect Sept. 22.