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National access data, a list of California vision programs, dated workforce data, and an editable worksheet for your own numbers. No generic scenario can predict your local financial results.
18 California programs, 8 FDA AI tools, and 9 charity partners. Updated 2026-09-04.
26%
FQHCs offering vision
Confirm
AI coverage and payment
+170%
OD growth since 2014
16%
CA Medi-Cal kids exam rate
Use the editable worksheet below to test your documented inputs. Its pre-filled values only demonstrate the arithmetic; they are not typical values, a recommendation, a forecast, or a promised return.
The pre-filled values are editable illustrations—not typical values, forecasts, recommendations, or a promised return. Replace every input with current, site-specific documentation before using the arithmetic in a decision.
ACU's dated survey had 39 anonymous responses (about 9% of the workforce); it is descriptive, not a market rate. Replace with the employer's written budgeted range.
Illustrative labor input. Replace it with a current written budget and the role definition for your site.
Illustrative comparison only; certification, duties, geography, and written pay range vary.
Use current written vendor quotes, build-out estimates, financing costs, and equipment scope.
Use local appointment supply, ramp, no-show, staffing, and eligibility assumptions. The ACU survey is descriptive, not a capacity forecast.
Use the applicable, documented site and payer rate. The pre-filled $300 is an illustration—not a floor, typical rate, or payment guarantee.
Illustrative input only. Replace it with measured local history or a deliberately conservative, documented planning assumption.
$879,750
Modeled PPS contribution: $663,750 + modeled dispensary gross profit: $216,000
Modeled gross PPS
$1,080,000
3,600 × $300
Total Cost
$416,250
Labor + supplies + capital
Simple capital recovery
2.7 mo
$200,000 invested
Modeled dispensary sales
$360,000
40% capture × $250
Input comparisons—not benchmarks
Planning arithmetic only—not an audited pro forma. It does not establish coverage, eligibility, collections, demand, profit, or payback. It omits or simplifies payer mix, denials, bad debt, optical-lab costs, occupancy, administration, financing, taxes, compliance, implementation timing, and other site-specific costs. No outcome is guaranteed.
Four prompts choose a record to investigate first. This is not a clinical, procurement, coverage, or financial recommendation.
Step 1/4 · Deployment model
Gaps in vision care are documented and growing. With a $47 Medi-Cal exam rate and 10% provider participation, FQHCs can be one practical way to expand access in California.
US diabetic patients screened with autonomous AI for retinopathy
0.09% (3,440 of 154,136 cases used CPT 92229 since 2021)
All US diabetic patients (estimated 38M+) · 2026
Ophthalmology Science (peer-reviewed)
School-age Medi-Cal kids who got an eye exam
16% (2022-2024) — DOWN from 19% eight years prior
California Medi-Cal pediatric · 2022-2024
CalMatters
California counties where pediatric eye exam rate worsened
47 of 58 counties (81%)
California pediatric Medi-Cal · 2022-2024
CalMatters
COA advocacy-reported Medi-Cal eye-exam fee context
Dated advocacy description only — verify the current DHCS schedule, code, locality, payer contract, eligibility, and FQHC billing treatment
California advocacy context; not a current allowed amount · 2026
California Optometric Association (advocacy source)
California Optometric Association members who accept Medi-Cal
~10%
California optometrists · 2026
California Optometric Association
Health-center patients without vision services / one-time federal investment to close the gap
10.7M patients lack vision services; ~$630M would fund ~1,070 optometrists + support staff (NACHC/ACU ask)
US community health center patients · 2025
NACHC — Vision Services Expansion Brief / ACU
Optometrists' eligibility for NHSC loan repayment (the FQHC vision-workforce barrier)
Still INELIGIBLE — NACHC's January 2026 CHC Workforce Policy Paper urges reinstating optometry as an NHSC-eligible discipline. A second barrier NACHC names in the same brief: there is no HPSA designation for eye care providers, so even NHSC inclusion would lack the designation machinery that routes awards
US FQHC optometrist recruitment · 2026
NACHC — CHC Workforce Policy Paper (Jan 2026)
LA Latinos with diabetes who have diabetic retinopathy (LALES)
~50%
Los Angeles Latino diabetic adults · Landmark study
NEI / Los Angeles Latino Eye Study (LALES)
LA Latinos with glaucoma who were undiagnosed before LALES
75%
Los Angeles Latino adults 40+ · Landmark study
NEI / LALES
Black Americans glaucoma prevalence vs white peers
5-6× higher; ~10 years earlier onset
Black Americans 40+ · 2025
Glaucoma Research Foundation
US FQHCs/CHCs offering on-site vision services
26-32% (435 of 1,362 in 2021 UDS)
National FQHC sector · 2021 UDS data
Woodward et al., Ophthalmology 2024
FQHC patients who receive eye care annually
2.6-2.94%
National FQHC patients · 2023
ACU Eye Care Workforce Factsheet 2025
Growth in optometry FTEs at US FQHCs since 2014
+170% (185 → 499.74 FTEs)
National FQHC sector · 2014-2023
ACU / HRSA UDS
US diabetic adults receiving yearly eye exam (HEDIS EED)
64.8% (target: 70.3%)
US adults with diabetes · Baseline
Healthy People 2030 D-04
Total US economic burden of vision loss
$134.2B ($98.7B direct + $35.5B indirect)
US population · 2021
Ophthalmology / AAO
Farmworkers who report never having visited an eye care professional
38%
US farmworkers · 2023
Migrant Clinicians Network / PMC
Share reported in one vendor-authored Cahaba implementation case
Reported >1-in-4; do not extrapolate
One Alabama FQHC implementation; not an expected rate · 2022
Digital Diagnostics / ADA Abstract 69-OR
LAUSD students provided eye exams + glasses by Vision To Learn
55,000+ exams, 44,000 glasses since 2017
LAUSD K-12 students · 2017-2026
Vision To Learn
From 2000 glaucoma authority to AB 2236 surgical-scope veto (2022) — what CA optometrists can and can't do for FQHC patients.
First glaucoma treatment authority granted with restrictive co-management requirements. Only 132 of 6,000+ CA ODs achieved certification in 8 years.
SourceSignificant expansion: glaucoma scope, prescribing authority, lab orders, child treatment scope. Removed mandatory ophthalmology consultation. ODs graduating after May 1, 2008 are auto glaucoma-certified.
SourceEarlier scope expansion authorizing certain anterior-segment treatments.
SourceTreats all non-cancerous anterior-segment conditions; topical/oral non-controlled, non-glaucoma Rx; immunizations (flu, herpes zoster, pneumococcus, SARS-CoV-2) after immunization cert; intense pulsed light, low-level light, intranasal stimulator, intracanalicular stents; assistants may perform subjective refraction.
SourceSARS-CoV-2 vaccinations and clinical lab testing by certified ODs (made permanent).
SourceWould have authorized therapeutic laser (SLT, peripheral iridotomy, posterior capsulotomy), lesion removal, corneal crosslinking by ODs. VETOED by Gov. Newsom Sept 2022 — veto rationale: surgical procedures require 3-yr residency vs. <1 yr OD training.
SourceProbationary registration with clinical training; raised Optometry Fund cap to 24 months; mobile optometric office registry (effective Jan 1, 2026); reduced Dispensing Optician Committee to 3 members.
SourceThe catalog below separates FDA authorization, published performance, documented deployments, and coverage context. Verify the current FDA indication, payer policy, coding, site workflow, contract terms, and local economics; authorization does not establish reimbursement or payback.
Digital Diagnostics
FDA De Novo decision April 2018 (DEN180001). Verify the current indication, labeling, supported hardware, and software version in the FDA record before use.
Sensitivity
87.2%
Specificity
90.7%
FQHC deployments:
Eyenuk
FDA 510(k) decision August 3, 2020 (K200667), with later device records. Verify the current indication, labeling, supported cameras, and software version before use.
Sensitivity
96% (more-than-mild DR), 92% (vision-threatening DR)
Specificity
88% (more-than-mild DR), 94% (vision-threatening DR)
FQHC deployments:
AEYE Health
FDA 510(k) decisions November 10, 2022 (K221183) and April 23, 2024 (K240058). Verify the current indication, labeling, supported hardware, and software version before use.
Sensitivity
93%
Specificity
91.4%
9 charity partners FQHCs can work with today. They range from VSP Eyes of Hope (based in Rancho Cordova) to Vision To Learn (75 California school districts) to Lions Eye Foundation (surgical backup for the Bay Area).
VSP Vision (Rancho Cordova HQ)
VSP reports charitable mobile-clinic, gift-certificate, disaster-response, and student-voucher programs. Verify current eligibility, geography, capacity, services, and terms directly.
Beutner Family Foundation (LA-founded 2012)
School-based mobile vision clinics: screening, exam, free glasses for K-12 students. Title I and Medicaid-covered models.
Warby Parker Foundation + Vision To Learn (CA partner)
School-based vision screenings, exams, free glasses. Buy a Pair, Give a Pair: 10M+ glasses delivered globally via VisionSpring.
EssilorLuxottica (consolidated 2022)
Sustainable vision centers, school clinics, disaster relief, low-cost screening tech. Consolidated 2022 from OneSight + Essilor Vision Foundation + Vision For Life.
Lions Clubs International Foundation (LCIF)
Grants for sight-saving infrastructure since 1990. Lions Eye Foundation of CA-NV provides free comprehensive ophthalmic care including cataract surgery for uninsured at 711 Van Ness Ave, San Francisco.
AOA Foundation
Free comprehensive eye + vision assessment for infants ages 6-12 months. Detects amblyopia, strabismus, and refractive errors at the critical visual development window.
AAO Foundation
Volunteer ophthalmologist medical eye exam + 1 year follow-up for diagnosed conditions. National volunteer network.
Optometry Cares — AOA Foundation
Free comprehensive exam by volunteer OD for uninsured adults. 430,000+ adults served across 40+ states since 1991.
National non-profit
Advocacy, vision screening certification, public awareness, partner on CDC VEHSS dashboard. Children's Vision Health Map (2024) tracks state/county indicators.
Vision programs among 213 California FQHCs. Flagship programs come first, then standard programs. Gaps in major markets are at the bottom (Asian Health Services, NEVHC, Open Door, TrueCare, Westside).
Bay Area
Major AAPI-serving FQHC with NO on-site optometry — significant gap given AAPI elevated angle-closure glaucoma + myopia risk.
Los Angeles
Large LA / San Fernando Valley FQHC with no confirmed optometry. Partners with MEND for vision in Pacoima.
North Coast
14-site rural North Coast FQHC network — no optometry confirmed in services list. Significant gap given remote service area.
San Diego
Large North County San Diego FQHC — no optometry confirmed.
Los Angeles
Santa Monica women's-health-focused FQHC — no optometry confirmed.
Lower, middle, and upper California pay references for vision roles from mixed sources, a descriptive 39-response FQHC OD survey, and the 3 ASCO-accredited OD programs in California. Together these sources do not make one market distribution.
| Role | CA lower | CA middle | CA upper | FQHC survey reference |
|---|---|---|---|---|
Optometrist (OD) ACU's 39-response anonymous survey reported different rural and urban averages; it did not establish a controlled recruitment premium or a market distribution. Optometrists were not NHSC-eligible in the cited FY2026 guidance. | $122,000 | $153,000 | $185,000 | $155,210 |
Ophthalmologist (MD/DO) Just 42 ophthalmology FTEs across all US FQHCs in 2023. J-1 Conrad 30 visa waivers eligible at CA FQHCs (no HPSA requirement for primary care). | $280,000 | $375,000 | $500,000 | — |
Optician (Dispensing) California has highest employment of opticians nationally (n=8,100). CA voluntary registration: SLD (spectacle), CLD (contact), RDO, NOLD. Unlicensed staff CAN dispense under direct OD supervision. | $45,000 | $59,960 | $75,000 | — |
Ophthalmic Technician (COA) JCAHPO 3 levels: COA (entry), COT (2,000 hrs as COA), COMT (advanced). 82% of FQHC optometrists have at least one technician. | $42,000 | $52,000 | $65,000 | — |
Ophthalmic Technician (COT) COT = intermediate level. Requires 2,000 hours as COA + 12 Group A CE credits. Significant pay bump from COA. | $55,000 | $63,000 | $78,000 | — |
Sources: BLS OEWS, ACU's 2023 FQHC Optometry Workforce Survey (39 anonymous respondents, about 9% of the workforce), JCAHPO, and other dated references. The lower/middle/upper columns compare mixed sources. They are not calculated percentiles. Verify the current source and employer range. The cited FY2026 NHSC guidance did not include optometrists.
Southern California College of Optometry (SCCO) at Marshall B. Ketchum University
Fullerton · Founded 1904
Founded 1904. ASCO-accredited. One of the oldest OD programs in the country.
UC Berkeley Herbert Wertheim School of Optometry & Vision Science
Berkeley · Founded 1923
Public, large program. Berkeley externship sites include Petaluma Health Center FQHC.
Western University of Health Sciences College of Optometry
Pomona · Founded 2009
Newest of CA's three OD schools. ASCO-accredited.
All our vision-care coverage, connected — start with the operating brief.
More operational detail lives across the site in case studies, OKR templates, the AI tracker, and advocacy actions.
Case studies
The Cahaba vendor case, the San Ysidro trial protocol, and FHCSD and Alliance program examples
OKR template
Vision service-line planning — 12-month operational template with locally set measures
AI tracker
FDA status, indications, studies, deployments, and coverage questions
Published examples
Published examples, with what each source shows and what to check locally
What to do
Optometrists are not eligible for NHSC, the biggest federal workforce barrier for FQHC vision care. The AOA is lobbying to add them.
View advocacy actions →