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SBPE Background Information

SBPE Background Information

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Published by: Editor on Apr 11, 2013
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09/30/2014

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SENATE BUSINESS, PROFESSIONS andECONOMIC DEVELOPMENT COMMITTEE
 Curren D. Price, Jr., Chair 
 
Background Information Sheet
 
SUBMIT 2 COPIES OF ALL BACKGROUND INFORMATION TOROOM 2053 & SEND ELECTRONICALLY, ALSO
TO:Kathleen.sullivan@sen.ca.gov MEASURE: SB 492 AUTHOR: Hernandez DATE: 4/9/13PLEASE TYPE1. Who is the source of the bill? What person, organization or entity requestedintroduction?
 Author 
2. What does your bill do?
SB 492 
will remove restrictions in current law to permit optometrists to examine,prevent, diagnose, and treat conditions and disorders of the visual system and thehuman eye to the full extent of their training. The bill permits an optometrist todiagnose, treat and manage additional conditions with ocular manifestations. Toensure public safety is of the highest priority, SB 492 will direct the State Board of Optometry to establish educational and examination requirements of optometristsincluding but not limited to completion of the National Board of Examiners inOptometry. Finally, this bill will permit optometrists to perform vaccinations and allowthem to perform surgical and non-surgical primary care procedures requiring nomore than topical or local anesthetic.
3. Describe existing law on this issue.
The Optometry Practice Act creates the State Board of Optometry, which licensesoptometrists and regulates their practice.
4.
What’s wrong with existing law? Why is this bill needed?
 Primary Care Physician Workforce Shortage
 According to a report commissioned by the California Health Care Foundation, thenumber of primary care physicians actively practicing in California is at the verybottom range of, or below, the state's need based on Council on Graduate MedicalEducation (Council) estimates. The distribution of these physicians is also poor. In2008, there were 69,460 actively practicing physicians in California, of which only 35percent reported practicing primary care. This equates to 63 active primary carephysicians in patient care per 100,000 persons. According to the Council, 60 to 80primary care physicians are needed per 100,000 in order to adequately meet theneeds of the population. When the same metric is applied regionally, only 16 of 
California’s
58 counties fall within the needed supply range for primary care
 
physicians. In other words, less than one third of Californians live in a communitywhere they have access to the health care services they need.
The ACA
 
 As a result of implementation of the ACA, about 4.7 million more Californians will beeligible for health insurance starting in 2014. The newly insured will increasedemand for health care on an already strained system. Furthermore, the ACA aimsto change how care is delivered. It will provide incentives for expanded andimproved primary care, which may affect demand for some health care professionalsmore than others, and create team-based models of service delivery. Researchindicates that health care reform will place higher skill demands on all members of the healthcare workforce as systems try to improve quality while limiting costs. Thescale of change with health care reform is unlike anything that the state haspreviously faced. Studies have found that persons with health insurance use morehealth care services than uninsured persons, particularly in primary care andpreventive services. This was found in Massachusetts, which experienced asubstantial increase in demand for primary care services as a result of its 2006health reform. Many newly insured Californians will have a pent-up demand for services and will create even more pressure on the already strained health caresystem, particularly in medically underserved areas.
Outdated Practice Acts
 A recent
New York Times
editori
al stated “
There is plenty of evidence that well-trainedhealth workers can provide routine service that is every bit as good or even better than what patients would receive from a doctor. And because they are paid less thanthe doctors, they can save the
patient and the healthcare system money.”
SB 493will allow for better utilization of our existing infrastructure of trained medicalproviders to bridge the provider gap through expanded practice.Californians deserve access to high quality primary care offered by a range of safe,efficient, and regulated providers. Physician assistants, nurse practitioners,pharmacists and optometrists have all significantly advanced their educational,testing, and certification programs over the past decade. They've enhanced clinicaltraining, moved to graduate or advanced degrees, and upgraded programaccreditation processes.Other states have recognized these advances with practice acts that align withprofessional competence and advanced education. But California's practice actshave not kept pace. We can no longer afford to get by on a fraction of our professional capacity. In California we have a robust network of providers that arewell-trained, evenly distributed throughout the state, regulated by the Department of Consumer Affairs and well positioned to pay particular attention to currentlyunderserved areas. Deploying these professionals in a team-based delivery modelwhere they work collaboratively with physicians will allow us to meet the demandsplaced on our healthcare systems created by a rapidly aging physician populationand expansion of health insurance coverage.

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