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.
LBD01275-10-0
A. 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 [phase
23 one 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 ocular
28 disease and pharmacology and may include both didactic and clinical
29 components.] 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 [and
36 evidence of the completion of this requirement shall be submitted with
37 each application for license renewal as required by section sixty-five
38 hundred 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 education
A. 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 and
55 recommend all nonprescription medications appropriate for ocular disease
56 whether intended for topical or oral use; and (ii)] to use and prescribe
A. 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.