Bill Text: NY A01193 | 2019-2020 | General Assembly | Amended
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--C 2019-2020 Regular Sessions IN ASSEMBLY January 14, 2019 ___________ Introduced by M. of A. PAULIN, COOK, CYMBROWITZ, ABINANTI, GUNTHER, WEPRIN, HEVESI, RYAN, 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, GARBARINO, MORINELLO, FITZPATRICK, DICKENS, MAGNARELLI, PICHARDO, SANTABARBARA, GIGLIO, D. ROSENTHAL, KIM, RODRI- GUEZ, ABBATE, JONES, ARROYO, VANEL, McDONOUGH, AUBRY, L. ROSENTHAL, 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, BUTTENSCHON, MALLIOTAKIS, EICHENSTEIN -- 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 -- again reported from said committee with amendments, ordered reprinted as amended and recommitted to said committee -- 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 EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD01275-10-0A. 1193--C 2 1 shall be limited to topical application to the surface of the eye for 2 therapeutic purposes and shall be limited to: 3 (i) antibiotic/antimicrobials; 4 (ii) decongestants/anti-allergenics; 5 (iii) non-steroidal anti-inflammatory agents; 6 (iv) steroidal anti-inflammatory agents; 7 (v) antiviral agents; 8 (vi) hyperosmotic/hypertonic agents; 9 (vii) cycloplegics; 10 (viii) artificial tears and lubricants; and 11 (ix) immunosuppressive agents. 12 § 2. Paragraph (f) of subdivision 1 of section 7101-a of the education 13 law, as added by chapter 517 of the laws of 1995, is amended to read as 14 follows: 15 (f) [Phase two therapeutic] Therapeutic pharmaceutical agents for 16 treatment of glaucoma and ocular hypertension. [Phase two] Therapeutic 17 pharmaceutical agents for treatment of glaucoma and ocular hypertension 18 shall mean those drugs which shall be limited to topical application to 19 the surface of the eye and shall be limited to: 20 (i) beta blockers; 21 (ii) alpha agonists; 22 (iii) direct acting cholinergic agents; 23 (iv) prostaglandin analogs; and 24 (v) carbonic anhydrase inhibitors. 25 § 3. Subdivision 1 of section 7101-a of the education law is amended 26 by adding a new paragraph (g) to read as follows: 27 (g) Oral therapeutic pharmaceutical agents. Oral therapeutic pharma- 28 ceutical agents shall mean those orally administered drugs used for 29 therapeutic purposes solely for the treatment of diseases of the eye and 30 adnexa and shall be limited to: 31 (i) the following antibiotics: 32 (1) amoxicillin/clavulanate potassium; 33 (2) cephalexin; 34 (3) azithromycin; 35 (4) sulfamethoxazole/trimethoprim; 36 (5) doxycycline; and 37 (6) tetracycline; 38 (ii) the following antiglaucoma agents used for the management of 39 acute increases in intraocular pressure; provided, however, an optome- 40 trist may use or prescribe a maximum of one twenty-four hour 41 prescription and shall immediately refer the patient to a licensed 42 physician specializing in diseases of the eye: 43 (1) acetazolamide; and 44 (2) methazolamide; and 45 (iii) the following antiviral agents used for herpes zoster ophthalmi- 46 cus; provided an optometrist shall use or prescribe in maximum, one 47 seven-day prescription; provided, however, if a patient is diagnosed 48 with herpes zoster ophthalmicus and has not already been examined by a 49 primary care physician or other appropriate physician for such viral 50 condition, an optometrist shall refer the patient to a licensed primary 51 care physician, licensed physician specializing in diseases of the eye, 52 or other appropriate physician within three days of such diagnosis: 53 (1) valacyclovir; and 54 (2) acyclovir.A. 1193--C 3 1 § 4. The subdivision heading and paragraph (a) of subdivision 4 of 2 section 7101-a of the education law, as added by chapter 517 of the laws 3 of 1995, are amended to read as follows: 4 [Phase one] Topical therapeutic pharmaceutical agents. (a) Before 5 using or prescribing [phase one] topical therapeutic pharmaceutical 6 agents, each optometrist shall have completed at least three hundred 7 hours of clinical training in the diagnosis, treatment and management of 8 patients with ocular disease other than glaucoma and ocular hyperten- 9 sion, not fewer than twenty-five hours of such training shall have been 10 completed subsequent to June thirtieth, nineteen hundred ninety-three 11 and additionally shall either have taken and successfully passed the 12 treatment and management of ocular diseases portion of the National 13 Board of Examiners in Optometry test or have taken and successfully 14 passed an examination acceptable to the board. 15 § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education 16 law, as added by chapter 517 of the laws of 1995, is amended to read as 17 follows: 18 (b) Before using or prescribing [phase two] therapeutic pharmaceutical 19 agents for treatment of glaucoma and ocular hypertension, an optometrist 20 must be certified for diagnostic and [phase one] topical therapeutic 21 agents and have completed an additional one hundred hours of clinical 22 training in the diagnosis, treatment and management of patients with 23 glaucoma and ocular hypertension, not fewer than twenty-five hours of 24 such training shall have been completed subsequent to July first, nine- 25 teen hundred ninety-four, and shall have taken and successfully passed 26 an oral or written examination acceptable by the board. 27 § 6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of the 28 education law are relettered paragraphs (d) and (e) and a new paragraph 29 (c) is added to read as follows: 30 (c) Before using or prescribing oral therapeutic pharmaceutical 31 agents, an optometrist must be certified to prescribe diagnostic pharma- 32 ceutical agents and topical therapeutic and therapeutic pharmaceutical 33 agents for treatment of glaucoma and ocular hypertension, have completed 34 an oral therapeutic pharmaceutical agent certification course and have 35 passed an examination within five years of the department's approval of 36 the initial certification course or the initial examination, whichever 37 is later provided, however, an optometrist who has commenced the oral 38 therapeutic pharmaceutical agent certification course within the five 39 year time period but has not yet passed an examination shall be allowed 40 to take such examination and become certified after the five year time 41 period provided for in this paragraph has ended. 42 (i) The curriculum for the oral therapeutic pharmaceutical agent 43 certification course shall include, but not be limited to, instruction 44 in pharmacology and drug interaction in treating ocular disease and be 45 taught through clinical case scenarios and emphasize clinical decision 46 making and shall be no less than forty hours, of which no less than 47 twenty-four hours shall be live instruction. 48 (ii) Such course shall qualify towards meeting the continuing educa- 49 tion per triennial registration requirement pursuant to subdivision 50 seven of this section. 51 (iii) The examination shall assess the knowledge of materials in the 52 curriculum and reflect the oral therapeutic pharmaceutical agents 53 described in paragraph (g) of subdivision one of this section, and shall 54 be acceptable to the department. 55 (iv) The initial, and any subsequent, curriculum and examination shall 56 be subject to review and approval by the department.A. 1193--C 4 1 (v) The requirement for the oral therapeutic pharmaceutical agent 2 certification course and examination shall not apply to those optome- 3 trists who graduated from an accredited college of optometry subsequent 4 to January first, two thousand twenty-one and have taken and successful- 5 ly passed the National Board of Examiners in Optometry examination or an 6 examination acceptable to the department. 7 § 7. Subdivision 5 of section 7101-a of the education law, as added by 8 chapter 517 of the laws of 1995, is amended to read as follows: 9 5. Suspension of certification. The department shall suspend the 10 certification for the use and prescribing of [phase one] topical thera- 11 peutic agents of any optometrist who fails to receive certification for 12 [phase two] therapeutic pharmaceutical agents for treatment of glaucoma 13 and ocular hypertension within three years of having been certified for 14 [phase one] topical therapeutic pharmaceutical agents. 15 § 8. The subdivision heading of subdivision 6 of section 7101-a of the 16 education law, as added by chapter 517 of the laws of 1995, is amended 17 to read as follows: 18 Consultation with use of certain topical therapeutic pharmaceutical 19 agents for treatment of glaucoma and ocular hypertension. 20 § 9. Subdivision 7 of section 7101-a of the education law, as added by 21 chapter 517 of the laws of 1995, is amended to read as follows: 22 7. Continuing education. (a) Each optometrist certified to use [phase23one or phase two] topical therapeutic pharmaceutical agents and thera- 24 peutic pharmaceutical agents for treatment of glaucoma and ocular hyper- 25 tension, shall complete a minimum of thirty-six hours of continuing 26 education in the area of ocular disease and pharmacology per triennial 27 registration period. [The education shall be in the area of ocular28disease and pharmacology and may include both didactic and clinical29components.] Each optometrist certified to use oral therapeutic pharma- 30 ceutical agents shall, in addition to the minimum thirty-six hours of 31 continuing education provided for in this subdivision, complete an addi- 32 tional minimum of eighteen hours of continuing education related to 33 systemic disease and therapeutic treatment per triennial registration 34 period. Such educational programs may include both didactic and clinical 35 components and shall be approved in advance by the department [and36evidence of the completion of this requirement shall be submitted with37each application for license renewal as required by section sixty-five38hundred two of this chapter]. Beginning on January first, two thousand 39 twenty-two, all sponsors of continuing education courses seeking 40 advanced approval from the department shall file an application and pay 41 a fee determined by the department in accordance with the regulations of 42 the commissioner. An optometrist subject to the provisions of this 43 subdivision whose first registration date following the effective date 44 of this section occurs less than three years from such effective date, 45 but on or after January first, two thousand twenty-two, shall complete 46 continuing education hours on a prorated basis at the rate of one hour 47 per month for the period beginning January first, two thousand twenty- 48 two up to the first registration date thereafter. An optometrist who has 49 not satisfied the mandatory continuing education requirement pursuant to 50 this subdivision shall not be issued a triennial registration certif- 51 icate by the department and shall not practice unless and until a condi- 52 tional registration is issued as provided for in paragraph (b) of this 53 subdivision. Continuing education hours taken during one triennium may 54 not be transferred to the subsequent triennium. 55 (b) The department, in its discretion, may issue a conditional regis- 56 tration to an optometrist who fails to meet the continuing educationA. 1193--C 5 1 requirements established in paragraph (a) of this subdivision, but who 2 agrees to make up any deficiencies and complete any additional education 3 which the department may require. The fee for such a conditional regis- 4 tration shall be the same as, and in addition to, the fee for the trien- 5 nial registration. The duration of such conditional registration shall 6 be determined by the department, but shall not exceed one year. Any 7 optometrist who is notified of the denial of registration for failure to 8 submit evidence, satisfactory to the department, of required continuing 9 education and who practices without such registration may be subject to 10 disciplinary proceedings pursuant to section sixty-five hundred ten of 11 this title. 12 (c) In accordance with the intent of this section, adjustment to the 13 mandatory continuing education requirement may be granted by the depart- 14 ment for reasons of health that are certified by an appropriate health 15 care professional, for extended active duty with the armed forces of the 16 United States, or for other good cause acceptable to the department 17 which may prevent compliance. 18 (d) An optometrist not engaged in practice, as determined by the 19 department, shall be exempt from the mandatory continuing education 20 requirement upon the filing of a statement with the department declaring 21 such status. Any licensee who returns to the practice of optometry 22 during the triennial registration period shall notify the department 23 prior to reentering the profession and shall meet such continuing educa- 24 tion requirements as shall be prescribed by regulations of the commis- 25 sioner. 26 (e) Optometrists subject to the provisions of this subdivision shall 27 maintain adequate documentation of completion of acceptable continuing 28 education credits and shall provide such documentation at the request of 29 the department. Failure to provide such documentation upon the request 30 of the department shall be an act of misconduct subject to disciplinary 31 proceedings pursuant to section sixty-five hundred ten of this title. 32 (f) The mandatory continuing education fee shall be determined by the 33 department. Such fee shall be payable on or before the first day of 34 each triennial registration period, and shall be paid in addition to the 35 triennial registration fee required by subdivision eight of section 36 seventy-one hundred four of this article. 37 § 10. The subdivision heading and subparagraph (i) of paragraph (a) of 38 subdivision 8 of section 7101-a of the education law, as added by chap- 39 ter 517 of the laws of 1995, are amended to read as follows: 40 Notice to patient with the use or prescription of topical therapeutic 41 pharmaceutical agents and therapeutic pharmaceutical agents for treat- 42 ment of glaucoma and ocular hypertension. 43 (i) An optometrist prescribing topical steroids or antiviral medica- 44 tion shall inform each patient that in the event the condition does not 45 improve within five days, a physician of the patient's choice will be 46 notified. 47 § 11. Subdivision 10 of section 7101-a of the education law, as added 48 by chapter 517 of the laws of 1995, is amended to read as follows: 49 10. Pharmaceutical agents. Optometrists who have been approved and 50 certified by the department shall be permitted to use the following 51 drugs: 52 (a) Diagnostic pharmaceuticals. 53 (b) Those optometrists having been certified for [phase one] topical 54 therapeutic pharmaceutical agents shall be authorized [(i) to use and55recommend all nonprescription medications appropriate for ocular disease56whether intended for topical or oral use; and (ii)] to use and prescribeA. 1193--C 6 1 all [phase one] topical therapeutic pharmaceutical agents specified in 2 paragraph (e) of subdivision one of this section, which are FDA approved 3 and commercially available for topical use. 4 In the event an optometrist treats a patient with topical antiviral or 5 steroidal drugs and the patient's condition either fails to improve or 6 worsens within five days, the optometrist shall notify a physician 7 designated by the patient or, if none, by the treating optometrist. 8 (c) Those optometrists having been certified for [phase two] therapeu- 9 tic pharmaceutical agents for treatment of glaucoma and ocular hyperten- 10 sion shall be authorized to use and prescribe [phase two] therapeutic 11 pharmaceutical agents for treatment of glaucoma and ocular hypertension 12 specified in paragraph (f) of subdivision one of this section, which are 13 FDA approved and commercially available. 14 (d) Those optometrists having been certified for oral therapeutic 15 pharmaceutical agents shall be authorized to use and prescribe oral 16 therapeutic pharmaceutical agents specified in paragraph (g) of subdivi- 17 sion one of this section, which are FDA approved and commercially avail- 18 able and shall comply with all safety information and side-effect and 19 warning advisories contained in the most current physicians' desk refer- 20 ence. 21 (e) Those optometrists having been certified for topical therapeutic 22 pharmaceutical agents, therapeutic pharmaceutical agents for treatment 23 of glaucoma and ocular hypertension or oral therapeutic pharmaceutical 24 agents shall be authorized to use and recommend all nonprescription 25 medications, whether intended for topical or oral use, appropriate for 26 the treatment of the eye and adnexa. 27 § 12. Subdivision 8 of section 7104 of the education law, as amended 28 by chapter 517 of the laws of 1995, is amended to read as follows: 29 (8) Fees: pay a fee of two hundred twenty dollars to the department 30 for admission to a department conducted examination and for an initial 31 license, a fee of one hundred fifteen dollars for each reexamination, a 32 fee of one hundred thirty-five dollars for an initial license for 33 persons not requiring admission to a department conducted examination, 34 [and] a fee of two hundred ten dollars for each triennial registration 35 period, [and] for additional authorization for the purpose of utilizing 36 diagnostic pharmaceutical agents, a fee of sixty dollars, and for 37 certification to use or prescribe oral therapeutic pharmaceutical 38 agents, a fee of two hundred fifty dollars. 39 § 13. This act shall take effect two years after it shall have become 40 a law; provided that section nine of this act shall take effect January 41 1, 2022. Effective immediately, the addition, amendment and/or repeal 42 of any rule or regulation necessary for the implementation of this act 43 on its effective date are authorized and directed to be made and 44 completed on or before such effective date.