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--A 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, ASHBY, FERNANDEZ, FALL, SMITH, BURKE, REILLY, REYES, SALKA, WALLACE, JACOBSON, JEAN-PIERRE, MOSLEY, MANKTELOW, TAYLOR, BENEDETTO, STERN, GRIFFIN, CRESPO, BUTTENSCHON -- Multi-Sponsored 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 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; 9 (ii) decongestants/anti-allergenics; 10 (iii) non-steroidal anti-inflammatory agents; EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD01275-04-9A. 1193--A 2 1 (iv) steroidal anti-inflammatory agents; 2 (v) antiviral agents; 3 (vi) hyperosmotic/hypertonic agents; 4 (vii) cycloplegics; 5 (viii) artificial tears and lubricants; and 6 (ix) immunosuppressive agents. 7 § 2. Paragraph (f) of subdivision 1 of section 7101-a of the education 8 law, as added by chapter 517 of the laws of 1995, is amended to read as 9 follows: 10 (f) [Phase two therapeutic] Therapeutic pharmaceutical agents for 11 treatment of glaucoma and ocular hypertension. [Phase two] Therapeutic 12 pharmaceutical agents for treatment of glaucoma and ocular hypertension 13 shall mean those drugs which shall be limited to topical application to 14 the surface of the eye and shall be limited to: 15 (i) beta blockers; 16 (ii) alpha agonists; 17 (iii) direct acting cholinergic agents; 18 (iv) prostaglandin analogs; and 19 (v) carbonic anhydrase inhibitors. 20 § 3. Subdivision 1 of section 7101-a of the education law is amended 21 by adding a new paragraph (g) to read as follows: 22 (g) Oral therapeutic pharmaceutical agents. Oral therapeutic pharma- 23 ceutical agents shall mean those orally administered drugs used for 24 therapeutic purposes solely for the treatment of diseases of the eye and 25 adnexa and shall be limited to: 26 (i) antibiotics; 27 (ii) decongestants/anti-allergenic/antihistamines; 28 (iii) antiglaucoma agents used for the management of acute increases 29 in intraocular pressure; provided, however, an optometrist may use or 30 prescribe a maximum of one twenty-four hour prescription and shall imme- 31 diately refer the patient to a licensed physician specializing in 32 diseases of the eye; 33 (iv) antiviral agents used for herpes zoster ophthalmicus; provided an 34 optometrist shall use or prescribe in maximum, one seven-day 35 prescription; provided, however, if a patient is diagnosed with herpes 36 zoster ophthalmicus and has not already been examined by a primary care 37 physician or other appropriate physician for such viral condition, an 38 optometrist shall refer the patient to a licensed primary care physi- 39 cian, licensed physician specializing in diseases of the eye, or other 40 appropriate physician within three days of such diagnosis; and 41 (v) non-steroidal anti-inflammatory agents. 42 § 4. The subdivision heading and paragraph (a) of subdivision 4 of 43 section 7101-a of the education law, as added by chapter 517 of the laws 44 of 1995, are amended to read as follows: 45 [Phase one] Topical therapeutic pharmaceutical agents. (a) Before 46 using or prescribing [phase one] topical therapeutic pharmaceutical 47 agents, each optometrist shall have completed at least three hundred 48 hours of clinical training in the diagnosis, treatment and management of 49 patients with ocular disease other than glaucoma and ocular hyperten- 50 sion, not fewer than twenty-five hours of such training shall have been 51 completed subsequent to June thirtieth, nineteen hundred ninety-three 52 and additionally shall either have taken and successfully passed the 53 treatment and management of ocular diseases portion of the National 54 Board of Examiners in Optometry test or have taken and successfully 55 passed an examination acceptable to the board.A. 1193--A 3 1 § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education 2 law, as added by chapter 517 of the laws of 1995, is amended to read as 3 follows: 4 (b) Before using or prescribing [phase two] therapeutic pharmaceutical 5 agents for treatment of glaucoma and ocular hypertension, an optometrist 6 must be certified for diagnostic and [phase one] topical therapeutic 7 agents and have completed an additional one hundred hours of clinical 8 training in the diagnosis, treatment and management of patients with 9 glaucoma and ocular hypertension, not fewer than twenty-five hours of 10 such training shall have been completed subsequent to July first, nine- 11 teen hundred ninety-four, and shall have taken and successfully passed 12 an oral or written examination acceptable by the board. 13 § 6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of the 14 education law are relettered paragraphs (d) and (e) and a new paragraph 15 (c) is added to read as follows: 16 (c) Before using or prescribing oral therapeutic pharmaceutical 17 agents, an optometrist must be certified to prescribe diagnostic pharma- 18 ceutical agents and topical therapeutic and therapeutic pharmaceutical 19 agents for treatment of glaucoma and ocular hypertension, have completed 20 an oral therapeutic pharmaceutical agent certification course and have 21 passed an examination within five years of the department's approval of 22 the initial certification course or the initial examination, whichever 23 is later provided, however, an optometrist who has commenced the oral 24 therapeutic pharmaceutical agent certification course within the five 25 year time period but has not yet passed an examination shall be allowed 26 to take such examination and become certified after the five year time 27 period provided for in this paragraph has ended. 28 (i) The curriculum for the oral therapeutic pharmaceutical agent 29 certification course shall include, but not be limited to, instruction 30 in pharmacology and drug interaction in treating ocular disease and be 31 taught through clinical case scenarios and emphasize clinical decision 32 making and shall be no less than forty hours, of which no less than 33 twenty-four hours shall be live instruction. 34 (ii) Such course shall qualify towards meeting the continuing educa- 35 tion per triennial registration requirement pursuant to subdivision 36 seven of this section. 37 (iii) The examination shall assess the knowledge of materials in the 38 curriculum and reflect the oral therapeutic pharmaceutical agents 39 described in paragraph (g) of subdivision one of this section, and shall 40 be acceptable to the department. 41 (iv) The initial, and any subsequent, curriculum and examination shall 42 be subject to review and approval by the department. 43 (v) The requirement for the oral therapeutic pharmaceutical agent 44 certification course and examination shall not apply to those optome- 45 trists who graduated from an accredited college of optometry subsequent 46 to January first, two thousand seven and have taken and successfully 47 passed the National Board of Examiners in Optometry examination or an 48 examination acceptable to the department. 49 § 7. Subdivision 5 of section 7101-a of the education law, as added by 50 chapter 517 of the laws of 1995, is amended to read as follows: 51 5. Suspension of certification. The department shall suspend the 52 certification for the use and prescribing of [phase one] topical thera- 53 peutic agents of any optometrist who fails to receive certification for 54 [phase two] therapeutic pharmaceutical agents for treatment of glaucoma 55 and ocular hypertension within three years of having been certified for 56 [phase one] topical therapeutic pharmaceutical agents.A. 1193--A 4 1 § 8. The subdivision heading of subdivision 6 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 Consultation with use of certain topical therapeutic pharmaceutical 5 agents for treatment of glaucoma and ocular hypertension. 6 § 9. Subdivision 7 of section 7101-a of the education law, as added by 7 chapter 517 of the laws of 1995, is amended to read as follows: 8 7. Continuing education. (a) Each optometrist certified to use [phase9one or phase two] topical therapeutic pharmaceutical agents and thera- 10 peutic pharmaceutical agents for treatment of glaucoma and ocular hyper- 11 tension, shall complete a minimum of thirty-six hours of continuing 12 education in the area of ocular disease and pharmacology per triennial 13 registration period. [The education shall be in the area of ocular14disease and pharmacology and may include both didactic and clinical15components.] Each optometrist certified to use oral therapeutic pharma- 16 ceutical agents shall, in addition to the minimum thirty-six hours of 17 continuing education provided for in this subdivision, complete an addi- 18 tional minimum of eighteen hours of continuing education related to 19 systemic disease and therapeutic treatment per triennial registration 20 period. Such educational programs may include both didactic and clinical 21 components and shall be approved in advance by the department [and22evidence of the completion of this requirement shall be submitted with23each application for license renewal as required by section sixty-five24hundred two of this chapter]. Beginning on January first, two thousand 25 twenty-two, all sponsors of continuing education courses seeking 26 advanced approval from the department shall file an application and pay 27 a fee determined by the department in accordance with the regulations of 28 the commissioner. An optometrist subject to the provisions of this 29 subdivision whose first registration date following the effective date 30 of this section occurs less than three years from such effective date, 31 but on or after January first, two thousand twenty-two, shall complete 32 continuing education hours on a prorated basis at the rate of one hour 33 per month for the period beginning January first, two thousand twenty- 34 two up to the first registration date thereafter. An optometrist who has 35 not satisfied the mandatory continuing education requirement pursuant to 36 this subdivision shall not be issued a triennial registration certif- 37 icate by the department and shall not practice unless and until a condi- 38 tional registration is issued as provided for in paragraph (b) of this 39 subdivision. Continuing education hours taken during one triennium may 40 not be transferred to the subsequent triennium. 41 (b) The department, in its discretion, may issue a conditional regis- 42 tration to an optometrist who fails to meet the continuing education 43 requirements established in paragraph (a) of this subdivision, but who 44 agrees to make up any deficiencies and complete any additional education 45 which the department may require. The fee for such a conditional regis- 46 tration shall be the same as, and in addition to, the fee for the trien- 47 nial registration. The duration of such conditional registration shall 48 be determined by the department, but shall not exceed one year. Any 49 optometrist who is notified of the denial of registration for failure to 50 submit evidence, satisfactory to the department, of required continuing 51 education and who practices without such registration may be subject to 52 disciplinary proceedings pursuant to section sixty-five hundred ten of 53 this title. 54 (c) In accordance with the intent of this section, adjustment to the 55 mandatory continuing education requirement may be granted by the depart- 56 ment for reasons of health that are certified by an appropriate healthA. 1193--A 5 1 care professional, for extended active duty with the armed forces of the 2 United States, or for other good cause acceptable to the department 3 which may prevent compliance. 4 (d) An optometrist not engaged in practice, as determined by the 5 department, shall be exempt from the mandatory continuing education 6 requirement upon the filing of a statement with the department declaring 7 such status. Any licensee who returns to the practice of optometry 8 during the triennial registration period shall notify the department 9 prior to reentering the profession and shall meet such continuing educa- 10 tion requirements as shall be prescribed by regulations of the commis- 11 sioner. 12 (e) Optometrists subject to the provisions of this subdivision shall 13 maintain adequate documentation of completion of acceptable continuing 14 education credits and shall provide such documentation at the request of 15 the department. Failure to provide such documentation upon the request 16 of the department shall be an act of misconduct subject to disciplinary 17 proceedings pursuant to section sixty-five hundred ten of this title. 18 (f) The mandatory continuing education fee shall be determined by the 19 department. Such fee shall be payable on or before the first day of 20 each triennial registration period, and shall be paid in addition to the 21 triennial registration fee required by subdivision eight of section 22 seventy-one hundred four of this article. 23 § 10. The subdivision heading and subparagraph (i) of paragraph (a) of 24 subdivision 8 of section 7101-a of the education law, as added by chap- 25 ter 517 of the laws of 1995, are amended to read as follows: 26 Notice to patient with the use or prescription of topical therapeutic 27 pharmaceutical agents and therapeutic pharmaceutical agents for treat- 28 ment of glaucoma and ocular hypertension. 29 (i) An optometrist prescribing topical steroids or antiviral medica- 30 tion shall inform each patient that in the event the condition does not 31 improve within five days, a physician of the patient's choice will be 32 notified. 33 § 11. Subdivision 10 of section 7101-a of the education law, as added 34 by chapter 517 of the laws of 1995, is amended to read as follows: 35 10. Pharmaceutical agents. Optometrists who have been approved and 36 certified by the department shall be permitted to use the following 37 drugs: 38 (a) Diagnostic pharmaceuticals. 39 (b) Those optometrists having been certified for [phase one] topical 40 therapeutic pharmaceutical agents shall be authorized [(i) to use and41recommend all nonprescription medications appropriate for ocular disease42whether intended for topical or oral use; and (ii)] to use and prescribe 43 all [phase one] topical therapeutic pharmaceutical agents specified in 44 paragraph (e) of subdivision one of this section, which are FDA approved 45 and commercially available for topical use. 46 In the event an optometrist treats a patient with topical antiviral or 47 steroidal drugs and the patient's condition either fails to improve or 48 worsens within five days, the optometrist shall notify a physician 49 designated by the patient or, if none, by the treating optometrist. 50 (c) Those optometrists having been certified for [phase two] therapeu- 51 tic pharmaceutical agents for treatment of glaucoma and ocular hyperten- 52 sion shall be authorized to use and prescribe [phase two] therapeutic 53 pharmaceutical agents for treatment of glaucoma and ocular hypertension 54 specified in paragraph (f) of subdivision one of this section, which are 55 FDA approved and commercially available.A. 1193--A 6 1 (d) Those optometrists having been certified for oral therapeutic 2 pharmaceutical agents shall be authorized to use and prescribe oral 3 therapeutic pharmaceutical agents specified in paragraph (g) of subdivi- 4 sion one of this section, which are FDA approved and commercially avail- 5 able and shall comply with all safety information and side-effect and 6 warning advisories contained in the most current physicians' desk refer- 7 ence. 8 (e) Those optometrists having been certified for topical therapeutic 9 pharmaceutical agents, therapeutic pharmaceutical agents for treatment 10 of glaucoma and ocular hypertension or oral therapeutic pharmaceutical 11 agents shall be authorized to use and recommend all nonprescription 12 medications, whether intended for topical or oral use, appropriate for 13 the treatment of the eye and adnexa. 14 § 12. Subdivision 8 of section 7104 of the education law, as amended 15 by chapter 517 of the laws of 1995, is amended to read as follows: 16 (8) Fees: pay a fee of two hundred twenty dollars to the department 17 for admission to a department conducted examination and for an initial 18 license, a fee of one hundred fifteen dollars for each reexamination, a 19 fee of one hundred thirty-five dollars for an initial license for 20 persons not requiring admission to a department conducted examination, 21 [and] a fee of two hundred ten dollars for each triennial registration 22 period, [and] for additional authorization for the purpose of utilizing 23 diagnostic pharmaceutical agents, a fee of sixty dollars, and for 24 certification to use or prescribe oral therapeutic pharmaceutical 25 agents, a fee of two hundred fifty dollars. 26 § 13. This act shall take effect two years after it shall have become 27 a law; provided that section nine of this act shall take effect on Janu- 28 ary 1, 2022. Effective immediately, the addition, amendment and/or 29 repeal of any rule or regulation necessary for the implementation of 30 this act on its effective date are authorized and directed to be made 31 and completed on or before such effective date.
