President’s Message

April has traditionally been that time of the year that we, as an organization, gather at the Capitol in Sacramento to discuss with our local lawmakers the bills we are working on for the year. And we are finally ready again to meet in person with our lawmakers, this time on June 27th! Previously thought it will be virtual once again, we are finally back in person. And we need your support more than ever as this is also an election year, and also, as I learned recently at the most recent Presidents’ council meeting, an unusual high number of influential lawmakers are leaving the Capitol this year, either because they are retiring, or running for higher office. Therefore, we need to be there in great numbers to put the face to our profession, and either strengthen or build new relationships with lawmakers. We don’t think often about this, but legislation has always been an important part of how we, as optometrists, are able to practice to the full scope of our training while increasing access to patients who benefit from our clinical expertise.

As with previous years, COA has put together an agenda outlining which bills it supports and how we, as primary eye care providers, can engage with our local legislators.

Here is a summary:

Scope of practice expansion (AB 2236) – For more than 20 years, patients in other states can go to their local optometrist to get the latest glaucoma treatment using lasers and remove small non-cancerous lesions from around the eye. COA is seeking legislation to allow optometrists to perform these procedures in California. We have a shortage of physicians that is getting worse because of the pandemic. A report from the Association of American Medical Colleges (AAMC) projects that the United States will face a shortage of between 54,100 and 139,000 physicians by 2033. At the same time, a higher percentage of people are over the age 65 and will need more eye care. We are extensively trained and can help elevate the doctor shortage if state law restrictions were removed.

Medi-Cal reimbursement rate increase – Medi-Cal reimbursement rates for optometric services have not been increased in over 20 years. In addition to the impact of inflation, optometrists have experienced increased costs because of the pandemic. As much as they want to, many optometrists can’t continue to accept Medi-Cal patients when reimbursement is far below the cost of providing care. Even though we live in a state with some of the highest overhead costs, California has the third worst Medicaid reimbursement rate for eye exams in the nation. The Medi-Cal reimbursement for a new patient exam and refraction is $47 where the national Medicaid average is $105. The average cost of an eye exam for a new patient with no insurance in California today is about $200. That is a significant difference that can’t be made up in volume.

PIA Eyeglasses (SB 1089) – The Prison Industry Authority (PIA) which fabricates eyeglasses for Medi-Cal recipients has had pandemic related closures at its prison facilities. As a result, an already significant turn-around wait time of 4-6 weeks has been more than doubled in some areas. The requirement to use the PIA to obtain eyeglasses is causing optometrists to stop accepting Medi-Cal because of the hassle involved. Poor children deserve timely, quality eyeglasses that are consistent with community durability standards. This new legislation would give patients an option to get their eyeglasses outside the PIA system.

Waiver of licensure fees for military personnel (SB 1237) – SB 1588 (Atkins) was signed into law in 2012 to require state licensure boards to waive the renewal fees, continuing education requirements, and other renewal requirements of any licensee who is called to active duty as a member of the US Armed Forces. The fee waiver has been interpreted by the Department of Consumer Affairs (DCA) to apply only if the licensee has had a “temporary” change in assignment to a remote location. DCA has ruled that “military personnel that have orders to serve in a permanent, career position at a base are not ‘called to active duty’ within the meaning of the exemption in AB 1588.” The COA is sponsoring SB 1237 (Newman) to waive the license renewal fee for any active-duty military licensee who is stationed outside of California, not just someone who was “called to active duty.” It’s unfair to require someone in the military to pay for a license that they must maintain, but can’t currently use. While fees are waived, no private practice of any type would be permitted. This bill would save optometry service members that are permanently stationed outside of California $425 every two years in renewal fees. We need to make sure our optometry military service members are not paying for a license they can’t use!

Temporary License Expansion (SB 509) – SB 509 (Wilk) was an urgency bill that was signed into law in 2021 to create a “temporary license” that allows an optometry school graduate to practice under the supervision of an optometrist or ophthalmologist if the graduate is unable to immediately take the required examination for licensure due to COVID-19. This new legislation would expand SB 509 to other declared state of emergencies beyond the COVID-19 pandemic. The intent is to allow a pathway to licensure in case of a future disasters that could cause the closure of the only testing site in Charlotte, North Carolina. SB 509 had no opposition and passed without any “no” votes.

Please consider joining us for Legislative Day, even if it is your first time! Every doctor makes us stronger! COA will walk you through all critical legislation beforehand. We will cover your travel costs for this day trip to the capitol. If you feel intimidated by the idea of discussing legislation with your local lawmakers in person, you can help via email. COA has on their website letters for each bill, ready to be personalized and sent out. Just log in to www.coavision.org, and follow the links under Government Affairs > Contact Your Legislator.

Ready to win one for optometry? Feel free to contact me at dr.simona@yahoo.com to learn how, and become a key to COA’s ongoing legislative success!