Bill Text: NY A01193 | 2019-2020 | General Assembly | Amended
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Requires optometrists to meet certain standards, including the completion of a course, to prescribe oral medications.
Spectrum: Slight Partisan Bill (Democrat 76-26)
Status: (Engrossed - Dead) 2020-07-21 - REFERRED TO RULES [A01193 Detail]
Download: New_York-2019-A01193-Amended.html
Bill Title: Requires optometrists to meet certain standards, including the completion of a course, to prescribe oral medications.
Spectrum: Slight Partisan Bill (Democrat 76-26)
Status: (Engrossed - Dead) 2020-07-21 - REFERRED TO RULES [A01193 Detail]
Download: New_York-2019-A01193-Amended.html
STATE OF NEW YORK ________________________________________________________________________ 1193--B 2019-2020 Regular Sessions IN ASSEMBLY January 14, 2019 ___________ Introduced by M. of A. PAULIN, COOK, CYMBROWITZ, ABINANTI, GUNTHER, WEPRIN, HEVESI, RYAN, TITUS, STIRPE, BUCHWALD, DiPIETRO, BRABENEC, BLAKE, FAHY, ORTIZ, COLTON, NORRIS, BARRETT, PHEFFER AMATO, DINOWITZ, LALOR, ZEBROWSKI, STECK, HUNTER, BRONSON, SOLAGES, PEOPLES-STOKES, DE LA ROSA, B. MILLER, RAIA, GARBARINO, MORINELLO, FITZPATRICK, DICK- ENS, MAGNARELLI, PICHARDO, SANTABARBARA, GIGLIO, D. ROSENTHAL, KIM, RODRIGUEZ, ABBATE, JONES, ARROYO, VANEL, McDONOUGH, AUBRY, L. ROSEN- THAL, ENGLEBRIGHT, LAVINE, D'URSO, JAFFEE, JOYNER, SEAWRIGHT, M. L. MILLER, FERNANDEZ, FALL, BURKE, REILLY, REYES, SALKA, WALLACE, JACOBSON, JEAN-PIERRE, MOSLEY, MANKTELOW, TAYLOR, BENEDETTO, STERN, GRIFFIN, CRESPO, BUTTENSCHON, MALLIOTAKIS, EICHENSTEIN -- Multi-Spon- sored by -- M. of A. BARCLAY, BLANKENBUSH, CAHILL, CARROLL, CROUCH, CUSICK, DAVILA, EPSTEIN, FRIEND, GALEF, GOODELL, GOTTFRIED, HAWLEY, LENTOL, LIFTON, LUPARDO, PALMESANO, PERRY, QUART, RIVERA, SIMOTAS, STEC, TAGUE, THIELE, WALSH, WOERNER, WRIGHT -- read once and referred to the Committee on Higher Education -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said commit- tee -- again reported from said committee with amendments, ordered reprinted as amended and recommitted to said committee AN ACT to amend the education law, in relation to the use of oral medi- cations by optometrists The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph (e) of subdivision 1 of section 7101-a of the 2 education law, as added by chapter 517 of the laws of 1995, is amended 3 to read as follows: 4 (e) [Phase one] Topical therapeutic pharmaceutical agents. [Phase one] 5 Topical therapeutic pharmaceutical agents shall mean those drugs which 6 shall be limited to topical application to the surface of the eye for 7 therapeutic purposes and shall be limited to: 8 (i) antibiotic/antimicrobials; EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD01275-08-9A. 1193--B 2 1 (ii) decongestants/anti-allergenics; 2 (iii) non-steroidal anti-inflammatory agents; 3 (iv) steroidal anti-inflammatory agents; 4 (v) antiviral agents; 5 (vi) hyperosmotic/hypertonic agents; 6 (vii) cycloplegics; 7 (viii) artificial tears and lubricants; and 8 (ix) immunosuppressive agents. 9 § 2. Paragraph (f) of subdivision 1 of section 7101-a of the education 10 law, as added by chapter 517 of the laws of 1995, is amended to read as 11 follows: 12 (f) [Phase two therapeutic] Therapeutic pharmaceutical agents for 13 treatment of glaucoma and ocular hypertension. [Phase two] Therapeutic 14 pharmaceutical agents for treatment of glaucoma and ocular hypertension 15 shall mean those drugs which shall be limited to topical application to 16 the surface of the eye and shall be limited to: 17 (i) beta blockers; 18 (ii) alpha agonists; 19 (iii) direct acting cholinergic agents; 20 (iv) prostaglandin analogs; and 21 (v) carbonic anhydrase inhibitors. 22 § 3. Subdivision 1 of section 7101-a of the education law is amended 23 by adding a new paragraph (g) to read as follows: 24 (g) Oral therapeutic pharmaceutical agents. Oral therapeutic pharma- 25 ceutical agents shall mean those orally administered drugs used for 26 therapeutic purposes solely for the treatment of diseases of the eye and 27 adnexa and shall be limited to: 28 (i) the following antibiotics: 29 (1) amoxicillin/clavulanate potassium; 30 (2) cephalexin; 31 (3) azithromycin; 32 (4) sulfamethoxazole/trimethoprim; 33 (5) doxycycline; and 34 (6) tetracycline; 35 (ii) the following antiglaucoma agents used for the management of 36 acute increases in intraocular pressure; provided, however, an optome- 37 trist may use or prescribe a maximum of one twenty-four hour 38 prescription and shall immediately refer the patient to a licensed 39 physician specializing in diseases of the eye: 40 (1) acetazolamide; and 41 (2) methazolamide; and 42 (iii) the following antiviral agents used for herpes zoster ophthalmi- 43 cus; provided an optometrist shall use or prescribe in maximum, one 44 seven-day prescription; provided, however, if a patient is diagnosed 45 with herpes zoster ophthalmicus and has not already been examined by a 46 primary care physician or other appropriate physician for such viral 47 condition, an optometrist shall refer the patient to a licensed primary 48 care physician, licensed physician specializing in diseases of the eye, 49 or other appropriate physician within three days of such diagnosis: 50 (1) valacyclovir; and 51 (2) acyclovir. 52 § 4. The subdivision heading and paragraph (a) of subdivision 4 of 53 section 7101-a of the education law, as added by chapter 517 of the laws 54 of 1995, are amended to read as follows: 55 [Phase one] Topical therapeutic pharmaceutical agents. (a) Before 56 using or prescribing [phase one] topical therapeutic pharmaceuticalA. 1193--B 3 1 agents, each optometrist shall have completed at least three hundred 2 hours of clinical training in the diagnosis, treatment and management of 3 patients with ocular disease other than glaucoma and ocular hyperten- 4 sion, not fewer than twenty-five hours of such training shall have been 5 completed subsequent to June thirtieth, nineteen hundred ninety-three 6 and additionally shall either have taken and successfully passed the 7 treatment and management of ocular diseases portion of the National 8 Board of Examiners in Optometry test or have taken and successfully 9 passed an examination acceptable to the board. 10 § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education 11 law, as added by chapter 517 of the laws of 1995, is amended to read as 12 follows: 13 (b) Before using or prescribing [phase two] therapeutic pharmaceutical 14 agents for treatment of glaucoma and ocular hypertension, an optometrist 15 must be certified for diagnostic and [phase one] topical therapeutic 16 agents and have completed an additional one hundred hours of clinical 17 training in the diagnosis, treatment and management of patients with 18 glaucoma and ocular hypertension, not fewer than twenty-five hours of 19 such training shall have been completed subsequent to July first, nine- 20 teen hundred ninety-four, and shall have taken and successfully passed 21 an oral or written examination acceptable by the board. 22 § 6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of the 23 education law are relettered paragraphs (d) and (e) and a new paragraph 24 (c) is added to read as follows: 25 (c) Before using or prescribing oral therapeutic pharmaceutical 26 agents, an optometrist must be certified to prescribe diagnostic pharma- 27 ceutical agents and topical therapeutic and therapeutic pharmaceutical 28 agents for treatment of glaucoma and ocular hypertension, have completed 29 an oral therapeutic pharmaceutical agent certification course and have 30 passed an examination within five years of the department's approval of 31 the initial certification course or the initial examination, whichever 32 is later provided, however, an optometrist who has commenced the oral 33 therapeutic pharmaceutical agent certification course within the five 34 year time period but has not yet passed an examination shall be allowed 35 to take such examination and become certified after the five year time 36 period provided for in this paragraph has ended. 37 (i) The curriculum for the oral therapeutic pharmaceutical agent 38 certification course shall include, but not be limited to, instruction 39 in pharmacology and drug interaction in treating ocular disease and be 40 taught through clinical case scenarios and emphasize clinical decision 41 making and shall be no less than forty hours, of which no less than 42 twenty-four hours shall be live instruction. 43 (ii) Such course shall qualify towards meeting the continuing educa- 44 tion per triennial registration requirement pursuant to subdivision 45 seven of this section. 46 (iii) The examination shall assess the knowledge of materials in the 47 curriculum and reflect the oral therapeutic pharmaceutical agents 48 described in paragraph (g) of subdivision one of this section, and shall 49 be acceptable to the department. 50 (iv) The initial, and any subsequent, curriculum and examination shall 51 be subject to review and approval by the department. 52 (v) The requirement for the oral therapeutic pharmaceutical agent 53 certification course and examination shall not apply to those optome- 54 trists who graduated from an accredited college of optometry subsequent 55 to January first, two thousand seven and have taken and successfullyA. 1193--B 4 1 passed the National Board of Examiners in Optometry examination or an 2 examination acceptable to the department. 3 § 7. Subdivision 5 of section 7101-a of the education law, as added by 4 chapter 517 of the laws of 1995, is amended to read as follows: 5 5. Suspension of certification. The department shall suspend the 6 certification for the use and prescribing of [phase one] topical thera- 7 peutic agents of any optometrist who fails to receive certification for 8 [phase two] therapeutic pharmaceutical agents for treatment of glaucoma 9 and ocular hypertension within three years of having been certified for 10 [phase one] topical therapeutic pharmaceutical agents. 11 § 8. The subdivision heading of subdivision 6 of section 7101-a of the 12 education law, as added by chapter 517 of the laws of 1995, is amended 13 to read as follows: 14 Consultation with use of certain topical therapeutic pharmaceutical 15 agents for treatment of glaucoma and ocular hypertension. 16 § 9. Subdivision 7 of section 7101-a of the education law, as added by 17 chapter 517 of the laws of 1995, is amended to read as follows: 18 7. Continuing education. (a) Each optometrist certified to use [phase19one or phase two] topical therapeutic pharmaceutical agents and thera- 20 peutic pharmaceutical agents for treatment of glaucoma and ocular hyper- 21 tension, shall complete a minimum of thirty-six hours of continuing 22 education in the area of ocular disease and pharmacology per triennial 23 registration period. [The education shall be in the area of ocular24disease and pharmacology and may include both didactic and clinical25components.] Each optometrist certified to use oral therapeutic pharma- 26 ceutical agents shall, in addition to the minimum thirty-six hours of 27 continuing education provided for in this subdivision, complete an addi- 28 tional minimum of eighteen hours of continuing education related to 29 systemic disease and therapeutic treatment per triennial registration 30 period. Such educational programs may include both didactic and clinical 31 components and shall be approved in advance by the department [and32evidence of the completion of this requirement shall be submitted with33each application for license renewal as required by section sixty-five34hundred two of this chapter]. Beginning on January first, two thousand 35 twenty-two, all sponsors of continuing education courses seeking 36 advanced approval from the department shall file an application and pay 37 a fee determined by the department in accordance with the regulations of 38 the commissioner. An optometrist subject to the provisions of this 39 subdivision whose first registration date following the effective date 40 of this section occurs less than three years from such effective date, 41 but on or after January first, two thousand twenty-two, shall complete 42 continuing education hours on a prorated basis at the rate of one hour 43 per month for the period beginning January first, two thousand twenty- 44 two up to the first registration date thereafter. An optometrist who has 45 not satisfied the mandatory continuing education requirement pursuant to 46 this subdivision shall not be issued a triennial registration certif- 47 icate by the department and shall not practice unless and until a condi- 48 tional registration is issued as provided for in paragraph (b) of this 49 subdivision. Continuing education hours taken during one triennium may 50 not be transferred to the subsequent triennium. 51 (b) The department, in its discretion, may issue a conditional regis- 52 tration to an optometrist who fails to meet the continuing education 53 requirements established in paragraph (a) of this subdivision, but who 54 agrees to make up any deficiencies and complete any additional education 55 which the department may require. The fee for such a conditional regis- 56 tration shall be the same as, and in addition to, the fee for the trien-A. 1193--B 5 1 nial registration. The duration of such conditional registration shall 2 be determined by the department, but shall not exceed one year. Any 3 optometrist who is notified of the denial of registration for failure to 4 submit evidence, satisfactory to the department, of required continuing 5 education and who practices without such registration may be subject to 6 disciplinary proceedings pursuant to section sixty-five hundred ten of 7 this title. 8 (c) In accordance with the intent of this section, adjustment to the 9 mandatory continuing education requirement may be granted by the depart- 10 ment for reasons of health that are certified by an appropriate health 11 care professional, for extended active duty with the armed forces of the 12 United States, or for other good cause acceptable to the department 13 which may prevent compliance. 14 (d) An optometrist not engaged in practice, as determined by the 15 department, shall be exempt from the mandatory continuing education 16 requirement upon the filing of a statement with the department declaring 17 such status. Any licensee who returns to the practice of optometry 18 during the triennial registration period shall notify the department 19 prior to reentering the profession and shall meet such continuing educa- 20 tion requirements as shall be prescribed by regulations of the commis- 21 sioner. 22 (e) Optometrists subject to the provisions of this subdivision shall 23 maintain adequate documentation of completion of acceptable continuing 24 education credits and shall provide such documentation at the request of 25 the department. Failure to provide such documentation upon the request 26 of the department shall be an act of misconduct subject to disciplinary 27 proceedings pursuant to section sixty-five hundred ten of this title. 28 (f) The mandatory continuing education fee shall be determined by the 29 department. Such fee shall be payable on or before the first day of 30 each triennial registration period, and shall be paid in addition to the 31 triennial registration fee required by subdivision eight of section 32 seventy-one hundred four of this article. 33 § 10. The subdivision heading and subparagraph (i) of paragraph (a) of 34 subdivision 8 of section 7101-a of the education law, as added by chap- 35 ter 517 of the laws of 1995, are amended to read as follows: 36 Notice to patient with the use or prescription of topical therapeutic 37 pharmaceutical agents and therapeutic pharmaceutical agents for treat- 38 ment of glaucoma and ocular hypertension. 39 (i) An optometrist prescribing topical steroids or antiviral medica- 40 tion shall inform each patient that in the event the condition does not 41 improve within five days, a physician of the patient's choice will be 42 notified. 43 § 11. Subdivision 10 of section 7101-a of the education law, as added 44 by chapter 517 of the laws of 1995, is amended to read as follows: 45 10. Pharmaceutical agents. Optometrists who have been approved and 46 certified by the department shall be permitted to use the following 47 drugs: 48 (a) Diagnostic pharmaceuticals. 49 (b) Those optometrists having been certified for [phase one] topical 50 therapeutic pharmaceutical agents shall be authorized [(i) to use and51recommend all nonprescription medications appropriate for ocular disease52whether intended for topical or oral use; and (ii)] to use and prescribe 53 all [phase one] topical therapeutic pharmaceutical agents specified in 54 paragraph (e) of subdivision one of this section, which are FDA approved 55 and commercially available for topical use.A. 1193--B 6 1 In the event an optometrist treats a patient with topical antiviral or 2 steroidal drugs and the patient's condition either fails to improve or 3 worsens within five days, the optometrist shall notify a physician 4 designated by the patient or, if none, by the treating optometrist. 5 (c) Those optometrists having been certified for [phase two] therapeu- 6 tic pharmaceutical agents for treatment of glaucoma and ocular hyperten- 7 sion shall be authorized to use and prescribe [phase two] therapeutic 8 pharmaceutical agents for treatment of glaucoma and ocular hypertension 9 specified in paragraph (f) of subdivision one of this section, which are 10 FDA approved and commercially available. 11 (d) Those optometrists having been certified for oral therapeutic 12 pharmaceutical agents shall be authorized to use and prescribe oral 13 therapeutic pharmaceutical agents specified in paragraph (g) of subdivi- 14 sion one of this section, which are FDA approved and commercially avail- 15 able and shall comply with all safety information and side-effect and 16 warning advisories contained in the most current physicians' desk refer- 17 ence. 18 (e) Those optometrists having been certified for topical therapeutic 19 pharmaceutical agents, therapeutic pharmaceutical agents for treatment 20 of glaucoma and ocular hypertension or oral therapeutic pharmaceutical 21 agents shall be authorized to use and recommend all nonprescription 22 medications, whether intended for topical or oral use, appropriate for 23 the treatment of the eye and adnexa. 24 § 12. Subdivision 8 of section 7104 of the education law, as amended 25 by chapter 517 of the laws of 1995, is amended to read as follows: 26 (8) Fees: pay a fee of two hundred twenty dollars to the department 27 for admission to a department conducted examination and for an initial 28 license, a fee of one hundred fifteen dollars for each reexamination, a 29 fee of one hundred thirty-five dollars for an initial license for 30 persons not requiring admission to a department conducted examination, 31 [and] a fee of two hundred ten dollars for each triennial registration 32 period, [and] for additional authorization for the purpose of utilizing 33 diagnostic pharmaceutical agents, a fee of sixty dollars, and for 34 certification to use or prescribe oral therapeutic pharmaceutical 35 agents, a fee of two hundred fifty dollars. 36 § 13. This act shall take effect two years after it shall have become 37 a law; provided that section nine of this act shall take effect January 38 1, 2022. Effective immediately, the addition, amendment and/or repeal 39 of any rule or regulation necessary for the implementation of this act 40 on its effective date are authorized and directed to be made and 41 completed on or before such effective date.
