Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
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Jun 12, 2018 |
referred to higher education delivered to assembly passed senate ordered to third reading cal.1715 |
Jun 05, 2018 |
reported and committed to rules |
May 08, 2018 |
reported and committed to finance |
Apr 26, 2018 |
print number 5235a |
Apr 26, 2018 |
amend and recommit to higher education |
Jan 03, 2018 |
referred to higher education |
Mar 16, 2017 |
referred to higher education |
Senate Bill S5235
2017-2018 Legislative Session
Relates to the use of oral medications by optometrists
download bill text pdfSponsored By
(R, C, IP) Senate District
Archive: Last Bill Status - In Assembly Committee
- Introduced
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- In Committee Assembly
- In Committee Senate
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- On Floor Calendar Assembly
- On Floor Calendar Senate
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- Passed Assembly
- Passed Senate
- Delivered to Governor
- Signed By Governor
Actions
Votes
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Floor Vote: Jun 12, 2018
aye (59)- Addabbo Jr.
- Akshar
- Alcantara
- Amedore
- Avella
- Bailey
- Benjamin
- Bonacic
- Boyle
- Breslin
- Brooks
- Carlucci
- Comrie
- DeFrancisco
- Dilan
- Felder
- Flanagan
- Funke
- Gallivan
- Gianaris
- Golden
- Hamilton
- Hannon
- Helming
- Hoylman-Sigal
- Jacobs
- Kaminsky
- Kavanagh
- Kennedy
- Klein
- Krueger
- LaValle
- Lanza
- Larkin
- Little
- Marcellino
- Marchione
- Mayer
- Montgomery
- Murphy
- O'Mara
- Ortt
- Parker
- Peralta
- Persaud
- Phillips
- Ritchie
- Rivera
- Robach
- Sanders Jr.
- Savino
- Serino
- Serrano
- Seward
- Stavisky
- Stewart-Cousins
- Tedisco
- Valesky
- Young
nay (2)
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Jun 12, 2018 - Rules Committee Vote
S523522Aye1Nay2Aye with Reservations0Absent0Excused0Abstained-
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Rules Committee Vote: Jun 12, 2018
aye (22)nay (1)
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May 8, 2018 - Higher Education Committee Vote
S523517Aye0Nay1Aye with Reservations0Absent0Excused0AbstainedJun 5, 2018 - Finance Committee Vote
S523534Aye0Nay3Aye with Reservations0Absent0Excused0Abstained-
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Finance Committee Vote: Jun 5, 2018
aye (34)aye wr (3)
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Bill Amendments
co-Sponsors
(D) 15th Senate District
(R, C, IP, RFM) Senate District
(D) Senate District
(R, C) 60th Senate District
(R, C, IP) Senate District
(R, C, IP) Senate District
(R, C, G, IP, SC) Senate District
(R, C) 58th Senate District
(R, C, IP) 62nd Senate District
(R, C, IP) Senate District
(R, C, IP) Senate District
(R, C, IP, RFM) Senate District
(D, IP) Senate District
(R, C, IP) Senate District
2017-S5235 - Details
2017-S5235 - Sponsor Memo
BILL NUMBER: S5235 Revised 03/16/17 TITLE OF BILL : An act to amend the education law, in relation to the use of oral medications by optometrists; and providing for the repeal of certain provisions upon expiration thereof PURPOSE OR GENERAL IDEA OF BILL : To authorize licensed optometrists who receive certification to prescribe certain oral medications SUMMARY OF SPECIFIC PROVISIONS : Sections one and two amend paragraphs (e) and (f) of subdivision 1 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to clarify the use of certain topical therapeutic pharmaceutical agents which are already authorized for use by optometrists and are the standard of care in the treatment of patients for certain eye conditions. Section three amends subdivision 1 of section 7101-a of the education law by adding a new paragraph (g) that sets forth the list of specific oral therapeutic pharmaceutical agents, including the generic equivalents of the listed drugs as provided, that optometrists, once
certified, will be authorized to prescribe and the conditions and limitations on the use of some drugs, including the referral of patients to licensed physicians as provided and the duration of certain prescriptions. Sections four and five amend paragraphs (a) and (b) of subdivision 4 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to replace the terms "phase one" and "phase two" with more descriptive terms related to the types of pharmaceutical agents optometrists are authorized to use. These amendments are made throughout the bill. Section six amends subdivision 4 of section 7101-a of the education law by re-lettering paragraphs (c) and (d) of said subdivision paragraphs (d) and (e), and by adding a new paragraph (c). Paragraph (c) provides that in order for an optometrist to be authorized to prescribe oral medications, such optometrist must be certified to prescribe diagnostic pharmaceutical agents and topical therapeutic and therapeutic pharmaceu- tical agents for the treatment of glaucoma and ocular hypertension, have completed a forty-hour oral therapeutic pharmaceutical agent certif- ication course and have passed an examination acceptable to the state board of optometry, with a curriculum developed by academic faculty representatives approved by the department of education (SED) from a New York State-accredited college of optometry and the departments of ophthalmology and pharmacology at New York state-accredited medical schools. The curriculum shall include instruction in pharmacology and drug interaction in treating ocular disease and shall be taught through clinical case scenarios and emphasize clinical decision-making. Optometrists must pass the examination within five years of completing the certification course, provided that an optometrist may be authorized to retake the examination beyond such timeframe upon application by the optometrist and a determination of good cause shown by the commissioner. The initial, and any subsequent, curriculum and examination shall be subject to review and approval by SED. Optometrists who graduated from an accredited college of optometry after January 1, 2007 and have passed the National Board of Examiners in Optometry or another examination will be eligible for certification and will not be required to complete the course or pass the examination. Section seven amends subdivision 5 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to specify that the suspension of certification for the use of topical therapeutic agents applies to an optometrist who fails to receive certification for therapeutic pharmaceutical agents for treatment of glaucoma and ocular hypertension. Section eight amends the subdivision heading of subdivision 6 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995. Section nine amends subdivision 7 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to require optometrists certified to use oral therapeutic pharmaceutical agents to complete an additional minimum of thirty-nine hours of continuing education related to systemic disease and therapeutic treatment, in addition to the minimum thirty-six hours of continuing education requirement, per triennial registration period. Section ten amends the subdivision heading and amends subparagraph (i) of paragraph (a) of subdivision 8 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to clarify the applicability of a separate notice to patients regarding the use of certain topical medications. Section eleven amends subdivision 10 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to provide that optometrists certified to use and prescribe oral medications shall be authorized to use and prescribe those oral medications that are FDA approved and commercially available. In addition, optometrists certified to prescribe topical and oral therapeutic pharmaceutical agents shall be authorized to use and recommend all nonprescription medications, whether intended for topical or oral use, appropriate for the treatment of the eye and adnexa. Section twelve amends section 7101-a of the education law to add a new subdivision 13 to require optometrists certified to prescribe oral therapeutic pharmaceutical agents to submit a form to SED on a quarterly basis detailing the optometrist's license number and national provider identifier, whether any oral prescriptions were issued and, when used, to include information related to the dosage of the agent, the date of the prescription, the patient's diagnosis, and whether a referral to a physician was made, if required. The requirements set forth in paragraph (a) of this subdivision shall remain in effect from the approval by SED of the initial oral therapeutic pharmaceutical agent certification course and examination and shall expire five years after such date. The Commissioner of Education will appoint a committee comprised of one pharmacist, one representative each on behalf of organized ophthalmology and optometry, and a public health expert who is neither an ophthalmologist nor an optometrist, to review submitted forms and cross-check against any available databases where prescriptions by optometrists are recorded to determine compliance by optometrists related to their use and prescription of oral therapeutic pharmaceutical agents and to identify any necessary enhancements to the curriculum provided for in this section and other educational materials and to assist in ensuring patient safety. If evidence of non-compliance is found, the committee shall refer such information to the Commissioner of Education and the State Office of Professions for investigation and, if applicable, disciplinary action. The bill affirms that the responsibilities of the committee shall not limit SED's authority to review, investigate and refer matters related to the professional conduct of a licensed provider. If one or more databases containing electronic prescriber information relating to oral therapeutic pharmaceutical agents prescribed or used by optometrists become available, and the Commissioner of Education determines and advises optometrists that quarterly reports are no longer necessary, then the committee shall review the database and ascertain the prescribing information for all optometrists consistent with this section. Section thirteen amends subdivision 8 of section 7104 of the education law, as amended by chapter 517 of the laws of 1995, to provide that applicants for a license as an optometrist shall pay an additional fee of one hundred dollars for certification to use or prescribe oral therapeutic pharmaceutical agents. Section fourteen provides the effective date. JUSTIFICATION : In 1995, the Legislature enacted a law authorizing a specialty certification for optometrists with training and experience to use topically applied therapeutic pharmaceutical agents for the treatment or prevention of ocular disease. By law, such certified optometrists are required to be held to the same standard of care in the diagnosis and treatment of patients, including the use of pharmaceutical agents, as the degree of skill and proficiency commonly exercised by a physician. In the years since the 1995 legislation was enacted, New Yorkers have enjoyed enhanced access to and a higher quality of primary eye care services provided by optometrists who meet the qualifications set forth in the law. This new legislation extends the 1995 legislation another modest step by allowing optometrists who complete additional coursework and pass an examination to become certified to prescribe for their patients certain oral medications for the treatment of eye disease. Currently, 48 states and the District of Columbia allow optometrists to prescribe and use a range of oral pharmaceutical agents for ocular conditions. This law will put New York on a parallel path with other states. Optometric students at SUNY College of Optometry are educated and trained in the prescription and use of these medications. The enactment of this legislation will provide optometrists the authority to treat patients with a limited number of medications for certain ocular diseases and will ensure that the prescribing optometrists are fully prepared to fulfill this responsibility. This bill is significantly more narrow than previously introduced legislation in that it would limit the number and types of oral medications that may be prescribed, promote greater coordination in care with a patient's physician, enhance the educational and training requirements for optometrists, limit the duration of certain oral drugs that are authorized to be used, and provide additional oversight of oral prescription practices by optometrists. The bill would, among other provisions, require optometrists who wish to prescribe and use oral medications to take a certification course and pass an examination approved by the Education Department. The applicant would be required to pass the examination within five years of completion of the course but would be permitted to retake the exam after that timeframe upon the Commissioner of Education's determination of good cause which would include circumstances related to an applicant's disability, illness including episodic and chronic and persistent conditions, limited English proficiency, adverse personal circumstances, or other circumstances as determined by the commissioner. PRIOR LEGISLATIVE HISTORY : A.9961-A, 2016 referred to higher education. Same as S.7440-A, 2016 passed Senate. Similar to A.2803, 2015 and 2016 referred to higher education. Similar to A.2192-A, 2013 and 2014 referred to higher education. Same as S.7678-A, 2013 and 2014 referred to higher education. Similar to A.363-B, 2011 and 2012 referred to higher education. Same as S.30277B, 2011 and 2012 referred to higher education. Similar to A.3718, 2009 and 2010 referred to higher education. Same as S.2667, 2009 and 2010 referred to higher education. Similar to A.8001, 2007 and 2008 referred to higher education. Same as S.4519, 2007-2008 referred to higher education. Similar to A.4329A, 2005 and 2006 referred to higher education. Same as S.2719-A, 2005 and 2006. Similar to A.7223, 2003 and 2004 referred to higher education. Same as S.2761, 2003 and 2004 referred to higher education. Similar to A.8814, 2001 and 2002 referred to higher education. Same as S.4482, 2001 and 2002 referred to higher education. FISCAL IMPLICATION : None to the State. EFFECTIVE DATE : This act shall take effect one year after it shall have become a law; provided that (i) subdivision 13 of section 7101-a of the education law added by section twelve of the act shall expire and be deemed repealed five years following the approval by the Department of Education of the initial certification course and examination pursuant to paragraph (c) of subdivision 4 of section 7101-a of the education law as added by section six of the act, (ii) the Commissioner of Education shall notify the legislative bill drafting commission upon approval of the initial certification course and examination required in section 6 of this act, and (iii) any rule or regulation necessary for the timely implementation of this act on its effective date shall be promulgated on or before such effective date.
2017-S5235 - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 5235 2017-2018 Regular Sessions I N S E N A T E March 16, 2017 ___________ Introduced by Sens. FUNKE, ADDABBO, GALLIVAN, LITTLE, MARCHIONE, O'MARA, ORTT, RITCHIE, SERINO, SEWARD, VALESKY, YOUNG -- read twice and ordered printed, and when printed to be committed to the Committee on Higher Education AN ACT to amend the education law, in relation to the use of oral medi- cations by optometrists; and providing for the repeal of certain provisions upon expiration thereof THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph (e) of subdivision 1 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: (e) [Phase one] TOPICAL therapeutic pharmaceutical agents. [Phase one] TOPICAL THERAPEUTIC pharmaceutical agents shall mean those drugs which shall be limited to topical application to the surface of the eye for therapeutic purposes and shall be limited to: (i) antibiotic/antimicrobials; (ii) decongestants/anti-allergenics; (iii) non-steroidal anti-inflammatory agents; (iv) steroidal anti-inflammatory agents; (v) antiviral agents; (vi) hyperosmotic/hypertonic agents; (vii) cycloplegics; (viii) artificial tears and lubricants; AND (IX) IMMUNOSUPPRESSIVE AGENTS. § 2. Paragraph (f) of subdivision 1 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: (f) [Phase two therapeutic] THERAPEUTIC pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION. [Phase two] THERAPEUTIC pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
LBD04288-03-7 S. 5235 2 shall mean those drugs which shall be limited to topical application to the surface of the eye and shall be limited to: (i) beta blockers; (ii) alpha agonists; (iii) direct acting cholinergic agents; (IV) PROSTAGLANDIN ANALOGS; AND (V) CARBONIC ANHYDRASE INHIBITORS. § 3. Subdivision 1 of section 7101-a of the education law is amended by adding a new paragraph (g) to read as follows: (G) ORAL THERAPEUTIC PHARMACEUTICAL AGENTS. ORAL THERAPEUTIC PHARMA- CEUTICAL AGENTS SHALL MEAN THOSE ORALLY ADMINISTERED DRUGS USED FOR THERAPEUTIC PURPOSES SOLELY FOR THE TREATMENT OF DISEASES OF THE EYE AND ADNEXA AND SHALL BE LIMITED TO: (I) THE FOLLOWING ANTIBIOTICS, INCLUDING, WHERE APPLICABLE, THE GENER- IC EQUIVALENT OF ANY OF THE LISTED DRUGS: (1) AUGMENTIN; (2) KEFLEX; (3) AZITHROMYCIN; (4) BACTRIM; (5) DOXYCYCLINE; AND (6) TETRACYCLINE; (II) THE FOLLOWING DECONGESTANTS/ANTI-ALLERGENIC/ANTIHISTAMINES, INCLUDING THE GENERIC EQUIVALENTS OF THE LISTED DRUGS: (1) CLARINEX; (2) XYZAL; AND (3) SINGULAIR; (III) THE FOLLOWING ANTIGLAUCOMA AGENTS, INCLUDING THE GENERIC EQUIV- ALENTS OF SUCH AGENTS, USED FOR THE MANAGEMENT OF ACUTE INCREASES IN INTRAOCULAR PRESSURE; PROVIDED, HOWEVER, AN OPTOMETRIST MAY USE OR PRESCRIBE A MAXIMUM OF ONE TWENTY-FOUR HOUR PRESCRIPTION AND SHALL IMME- DIATELY REFER THE PATIENT TO A LICENSED PHYSICIAN SPECIALIZING IN DISEASES OF THE EYE: (1) DIAMOX; AND (2) NEPTAZANE; (IV) THE FOLLOWING ANTIVIRAL AGENTS FOR HERPES ZOSTER OPHTHALMICUS; PROVIDED AN OPTOMETRIST SHALL USE OR PRESCRIBE IN MAXIMUM, SEVEN-DAY PRESCRIPTIONS; PROVIDED, HOWEVER, IF A PATIENT IS DIAGNOSED WITH HERPES ZOSTER OPHTHALMICUS AND HAS NOT ALREADY BEEN EXAMINED BY A PRIMARY CARE PHYSICIAN OR OTHER APPROPRIATE PHYSICIAN FOR SUCH VIRAL CONDITION, AN OPTOMETRIST SHALL REFER THE PATIENT TO A LICENSED PRIMARY CARE PHYSI- CIAN, LICENSED PHYSICIAN SPECIALIZING IN DISEASES OF THE EYE, OR OTHER APPROPRIATE PHYSICIAN WITHIN THREE DAYS OF SUCH DIAGNOSIS: (1) VALACYCLOVIR; AND (2) ACYCLOVIR; AND (V) THE FOLLOWING NON-STEROIDAL ANTI-INFLAMMATORY AGENTS: (1) COX-2 INHIBITORS; (2) IBUPROFEN; AND (3) NAPROXEN. § 4. The subdivision heading and paragraph (a) of subdivision 4 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: [Phase one] TOPICAL therapeutic pharmaceutical agents. (a) Before using or prescribing [phase one] TOPICAL therapeutic pharmaceutical agents, each optometrist shall have completed at least three hundred hours of clinical training in the diagnosis, treatment and management of patients with ocular disease other than glaucoma and ocular hyperten- S. 5235 3 sion, not fewer than twenty-five hours of such training shall have been completed subsequent to June thirtieth, nineteen hundred ninety-three and additionally shall either have taken and successfully passed the treatment and management of ocular diseases portion of the National Board of Examiners in Optometry test or have taken and successfully passed an examination acceptable to the board. § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: (b) Before using or prescribing [phase two] therapeutic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION, an optometrist must be certified for diagnostic and [phase one] TOPICAL therapeutic agents and have completed an additional one hundred hours of clinical training in the diagnosis, treatment and management of patients with glaucoma and ocular hypertension, not fewer than twenty-five hours of such training shall have been completed subsequent to July first, nine- teen hundred ninety-four, and shall have taken and successfully passed an oral or written examination acceptable by the board. § 6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of the education law are relettered paragraphs (d) and (e) and a new paragraph (c) is added to read as follows: (C) BEFORE USING OR PRESCRIBING ORAL THERAPEUTIC PHARMACEUTICAL AGENTS, AN OPTOMETRIST MUST BE CERTIFIED TO PRESCRIBE DIAGNOSTIC PHARMA- CEUTICAL AGENTS AND TOPICAL THERAPEUTIC AND THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION, HAVE COMPLETED AN ORAL THERAPEUTIC PHARMACEUTICAL AGENT CERTIFICATION COURSE AND HAVE PASSED AN EXAMINATION WITHIN FIVE YEARS OF COMPLETION OF THE CERTIF- ICATION COURSE. THE CURRICULUM SHALL BE DEVELOPED BY ACADEMIC FACULTY REPRESENTATIVES APPROVED BY THE DEPARTMENT FROM A NEW YORK STATE ACCRED- ITED COLLEGE OF OPTOMETRY, FROM A DEPARTMENT OF OPHTHALMOLOGY AT A NEW YORK STATE ACCREDITED MEDICAL SCHOOL UPON THE RECOMMENDATION OF A STATE- WIDE PROFESSIONAL ORGANIZATION CONSISTING OF OPHTHALMOLOGISTS, AND FROM A DEPARTMENT OF PHARMACOLOGY AT A NEW YORK STATE ACCREDITED MEDICAL SCHOOL. (I) THE CURRICULUM SHALL INCLUDE, BUT NOT BE LIMITED TO, INSTRUCTION IN PHARMACOLOGY AND DRUG INTERACTION IN TREATING OCULAR DISEASE AND BE TAUGHT THROUGH CLINICAL CASE SCENARIOS AND EMPHASIZE CLINICAL DECISION MAKING AND SHALL BE NO LESS THAN FORTY HOURS, OF WHICH NO LESS THAN TWENTY-FOUR HOURS SHALL BE LIVE INSTRUCTION. (II) SUCH COURSE SHALL QUALIFY TOWARDS MEETING THE CONTINUING EDUCA- TION PER TRIENNIAL REGISTRATION REQUIREMENT PURSUANT TO SUBDIVISION SEVEN OF THIS SECTION. (III) THE EXAMINATION SHALL TEST THE KNOWLEDGE OF MATERIALS IN THE CURRICULUM AND REFLECT THE PROVISIONS OF PARAGRAPH (G) OF SUBDIVISION ONE OF THIS SECTION, AND SHALL BE ACCEPTABLE TO THE BOARD. IF AN OPTO- METRIST FAILS TO PASS THE EXAMINATION, SUCH OPTOMETRIST MAY RETAKE THE EXAMINATION FOLLOWING COMPLETION OF THE CERTIFICATION COURSE, PROVIDED THAT IF AN OPTOMETRIST REQUIRES MORE TIME TO PASS THE EXAMINATION THAN PROVIDED FOR IN THIS PARAGRAPH, SUCH OPTOMETRIST MAY BE AUTHORIZED TO RETAKE THE EXAMINATION BEYOND THE PERIOD PROVIDED FOR IN THIS PARAGRAPH UPON APPLICATION BY THE OPTOMETRIST AND A DETERMINATION OF GOOD CAUSE SHOWN BY THE COMMISSIONER. (IV) THE INITIAL, AND ANY SUBSEQUENT, CURRICULUM AND EXAMINATION SHALL BE SUBJECT TO REVIEW AND APPROVAL BY THE DEPARTMENT. (V) THE REQUIREMENT FOR THE ORAL THERAPEUTIC PHARMACEUTICAL AGENT CERTIFICATION COURSE AND EXAMINATION SHALL NOT APPLY TO THOSE OPTOME- S. 5235 4 TRISTS WHO GRADUATED FROM AN ACCREDITED COLLEGE OF OPTOMETRY SUBSEQUENT TO JANUARY FIRST, TWO THOUSAND SEVEN AND HAVE TAKEN AND SUCCESSFULLY PASSED THE NATIONAL BOARD OF EXAMINERS IN OPTOMETRY TEST OR AN EXAMINA- TION ACCEPTABLE TO THE BOARD. § 7. Subdivision 5 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: 5. Suspension of certification. The department shall suspend the certification for the use and prescribing of [phase one] TOPICAL thera- peutic agents of any optometrist who fails to receive certification for [phase two] therapeutic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION within three years of having been certified for [phase one] TOPICAL therapeutic pharmaceutical agents. § 8. The subdivision heading of subdivision 6 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: Consultation WITH USE OF CERTAIN TOPICAL THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION. § 9. Subdivision 7 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: 7. Continuing education. Each optometrist certified to use [phase one or phase two] TOPICAL THERAPEUTIC PHARMACEUTICAL AGENTS AND therapeutic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION, shall complete a minimum of thirty-six hours of continuing education IN THE AREA OF OCULAR DISEASE AND PHARMACOLOGY per triennial registration period. [The education shall be in the area of ocular disease and phar- macology and may include both didactic and clinical components.] EACH OPTOMETRIST CERTIFIED TO USE ORAL THERAPEUTIC PHARMACEUTICAL AGENTS SHALL, IN ADDITION TO THE MINIMUM THIRTY-SIX HOURS OF CONTINUING EDUCA- TION PROVIDED FOR IN THIS SUBDIVISION, COMPLETE AN ADDITIONAL MINIMUM OF THIRTY-NINE HOURS OF CONTINUING EDUCATION RELATED TO SYSTEMIC DISEASE AND THERAPEUTIC TREATMENT PER TRIENNIAL REGISTRATION PERIOD. Such educa- tional programs MAY INCLUDE BOTH DIDACTIC AND CLINICAL COMPONENTS AND shall be approved in advance by the department and evidence of the completion of this requirement shall be submitted with each application for license renewal as required by section sixty-five hundred two of this chapter. § 10. The subdivision heading and subparagraph (i) of paragraph (a) of subdivision 8 of section 7101-a of the education law, as added by chap- ter 517 of the laws of 1995, are amended to read as follows: Notice to patient WITH THE USE OR PRESCRIPTION OF TOPICAL THERAPEUTIC PHARMACEUTICAL AGENTS AND THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREAT- MENT OF GLAUCOMA AND OCULAR HYPERTENSION. (i) An optometrist prescribing TOPICAL steroids or antiviral medica- tion shall inform each patient that in the event the condition does not improve within five days, a physician of the patient's choice will be notified. § 11. Subdivision 10 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: 10. Pharmaceutical agents. Optometrists who have been approved and certified by the department shall be permitted to use the following drugs: (a) Diagnostic pharmaceuticals. (b) Those optometrists having been certified for [phase one] TOPICAL therapeutic pharmaceutical agents shall be authorized [(i) to use and recommend all nonprescription medications appropriate for ocular disease whether intended for topical or oral use; and (ii)] to use and prescribe S. 5235 5 all [phase one] TOPICAL therapeutic pharmaceutical agents SPECIFIED IN PARAGRAPH (E) OF SUBDIVISION ONE OF THIS SECTION, which are FDA approved and commercially available FOR TOPICAL USE. In the event an optometrist treats a patient with topical antiviral or steroidal drugs and the patient's condition either fails to improve or worsens within five days, the optometrist shall notify a physician designated by the patient or, if none, by the treating optometrist. (c) Those optometrists having been certified for [phase two] therapeu- tic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTEN- SION shall be authorized to use and prescribe [phase two] therapeutic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION SPECIFIED IN PARAGRAPH (F) OF SUBDIVISION ONE OF THIS SECTION, which are FDA approved and commercially available. (D) THOSE OPTOMETRISTS HAVING BEEN CERTIFIED FOR ORAL THERAPEUTIC PHARMACEUTICAL AGENTS SHALL BE AUTHORIZED TO USE AND PRESCRIBE ORAL THERAPEUTIC PHARMACEUTICAL AGENTS SPECIFIED IN PARAGRAPH (G) OF SUBDIVI- SION ONE OF THIS SECTION, WHICH ARE FDA APPROVED AND COMMERCIALLY AVAIL- ABLE AND SHALL COMPLY WITH ALL SAFETY INFORMATION AND SIDE-EFFECT AND WARNING ADVISORIES CONTAINED IN THE MOST CURRENT PHYSICIANS' DESK REFER- ENCE. (E) THOSE OPTOMETRISTS HAVING BEEN CERTIFIED FOR TOPICAL THERAPEUTIC PHARMACEUTICAL AGENTS, THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION OR ORAL THERAPEUTIC PHARMACEUTICAL AGENTS SHALL BE AUTHORIZED TO USE AND RECOMMEND ALL NONPRESCRIPTION MEDICATIONS, WHETHER INTENDED FOR TOPICAL OR ORAL USE, APPROPRIATE FOR THE TREATMENT OF THE EYE AND ADNEXA. § 12. Section 7101-a of the education law is amended by adding a new subdivision 13 to read as follows: 13. ORAL THERAPEUTIC PHARMACEUTICAL AGENT IMPLEMENTATION REVIEW. (A) EACH OPTOMETRIST CERTIFIED TO USE ORAL THERAPEUTIC PHARMACEUTICAL AGENTS PURSUANT TO PARAGRAPH (C) OF SUBDIVISION FOUR OF THIS SECTION SHALL PROVIDE THE DEPARTMENT WITH INFORMATION, ON A FORM PRESCRIBED BY THE COMMISSIONER, RELATED TO THE PRESCRIPTION OR USE OF ORAL THERAPEUTIC PHARMACEUTICAL AGENTS PROVIDED FOR IN THIS SECTION. SUCH INFORMATION SHALL INCLUDE THE OPTOMETRIST'S LICENSE NUMBER AND THE NATIONAL PROVIDER IDENTIFIER AS ESTABLISHED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES, WHETHER NO ORAL PRESCRIPTIONS HAVE BEEN ISSUED AND IN THE EVENT THAT ORAL PRESCRIPTIONS HAVE BEEN ISSUED, THEN THE FOLLOWING INFORMATION SHALL BE REQUIRED: THE PRESCRIBED OR USED ORAL THERAPEUTIC PHARMACEUTICAL AGENT, THE DOSAGE OF SUCH AGENT, THE DATE OF THE PRESCRIPTION, THE DIAGNOSIS OF THE PATIENT FOR WHICH THE AGENT WAS PRESCRIBED OR USED, AND WHETHER A REFERRAL WAS MADE IN ACCORDANCE WITH PARAGRAPH (G) OF SUBDIVISION ONE OF THIS SECTION. SUCH INFORMATION SHALL NOT INCLUDE ANY PATIENT IDENTIFYING INFORMATION AND MUST OTHERWISE BE IN COMPLIANCE WITH ALL STATE AND FEDERAL REQUIREMENTS RELATED TO PROTECTED HEALTH INFORMATION. EACH FORM SHALL BE SUBMITTED BY MAIL OR ELECTRONIC MEANS TO THE DEPARTMENT ON A QUARTERLY BASIS. IF A DATABASE OF ALL ORAL THERAPEUTIC PHARMACEUTICAL AGENTS PRESCRIBED OR USED BY OPTOMETRISTS IS, OR BECOMES, AVAILABLE TO THE COMMITTEE PROVIDED FOR IN THIS SUBDIVISION, THEN OPTOMETRISTS WILL BE ADVISED BY THE COMMISSIONER THAT QUARTERLY REPORTING FORMS WILL NO LONGER BE REQUIRED. THE REQUIRE- MENTS OF THIS PARAGRAPH SHALL REMAIN IN EFFECT FOR FIVE YEARS FOLLOWING APPROVAL BY THE DEPARTMENT OF THE INITIAL ORAL THERAPEUTIC PHARMACEU- TICAL AGENT CERTIFICATION COURSE AND EXAMINATION PURSUANT TO PARAGRAPH (C) OF SUBDIVISION FOUR OF THIS SECTION, AFTER WHICH TIME THESE REQUIRE- MENTS SHALL EXPIRE AND NO LONGER HAVE EFFECT. S. 5235 6 (B) THE COMMISSIONER SHALL APPOINT A COMMITTEE TO ADVISE AND ASSIST THE COMMISSIONER IN EVALUATING COMPLIANCE WITH THE PROVISIONS OF THIS SECTION AND TO IDENTIFY ANY NECESSARY ENHANCEMENTS TO THE CURRICULUM PROVIDED FOR IN THIS SECTION AND OTHER EDUCATIONAL MATERIALS AND TO ASSIST IN ENSURING PATIENT SAFETY. THE COMMITTEE SHALL CONSIST OF ONE PHARMACIST, ONE OPTOMETRIST UPON THE RECOMMENDATION OF A STATEWIDE PROFESSIONAL ORGANIZATION CONSISTING OF OPTOMETRISTS, ONE OPHTHALMOLO- GIST UPON THE RECOMMENDATION OF A STATEWIDE PROFESSIONAL ORGANIZATION CONSISTING OF OPHTHALMOLOGISTS, AND ONE EXPERT IN THE FIELD OF PUBLIC HEALTH WHO SHALL BE DESIGNATED AS CHAIR BY THE COMMISSIONER IN CONSULTA- TION WITH THE COMMISSIONER OF THE DEPARTMENT OF HEALTH AND WHO SHALL BE NEITHER AN OPHTHALMOLOGIST NOR AN OPTOMETRIST. (C) THE COMMISSIONER SHALL SUBMIT EACH FORM RECEIVED PURSUANT TO THIS SUBDIVISION TO THE COMMITTEE, EXCEPT AS OTHERWISE PROVIDED IN THIS PARA- GRAPH. THE COMMITTEE SHALL REVIEW THE FORMS AND SHALL RANDOMLY CROSS- CHECK SUCH SUBMISSIONS WITH A PUBLICLY AVAILABLE OR OTHER DATABASE CONTAINING ELECTRONIC PRESCRIBER INFORMATION. SHOULD A DATABASE OF ALL ORAL THERAPEUTIC PHARMACEUTICAL AGENTS PRESCRIBED OR USED BY OPTOME- TRISTS BECOME AVAILABLE PURSUANT TO THIS SECTION, AND THE COMMISSIONER DETERMINES AND ADVISES OPTOMETRISTS THAT QUARTERLY REPORTS ARE NO LONGER NECESSARY, THEN THE COMMITTEE SHALL REVIEW THE DATABASE AND ASCERTAIN THE PRESCRIBING INFORMATION FOR ALL OPTOMETRISTS CONSISTENT WITH THIS SECTION. THE COMMITTEE SHALL ADVISE THE COMMISSIONER AS TO COMPLIANCE WITH THE PROVISIONS OF THIS SECTION FOR THE PURPOSE OF EVALUATING COMPLIANCE WITH THE PROVISIONS OF THIS SECTION INCLUDING THE APPLICABLE REFERRALS AND DOSING LIMITATIONS AND TO IDENTIFY ANY NECESSARY ENHANCE- MENTS TO THE CURRICULUM PROVIDED FOR IN THIS SECTION AND OTHER EDUCA- TIONAL MATERIALS AND TO ASSIST IN ENSURING PATIENT SAFETY. UPON FINDING EVIDENCE OF NON-COMPLIANCE BY ANY OPTOMETRIST, THE COMMITTEE SHALL REFER SUCH INFORMATION TO THE COMMISSIONER AND TO THE OFFICE OF PROFESSIONS FOR INVESTIGATION AND, IF APPLICABLE, DISCIPLINARY ACTION. NOTHING IN THIS PARAGRAPH IS INTENDED TO MODIFY OR OTHERWISE LIMIT THE DEPARTMENT'S AUTHORITY TO REVIEW, INVESTIGATE AND REFER MATTERS RELATED TO THE PROFESSIONAL CONDUCT OF A LICENSED PROVIDER. § 13. Subdivision 8 of section 7104 of the education law, as amended by chapter 517 of the laws of 1995, is amended to read as follows: (8) Fees: pay a fee of two hundred twenty dollars to the department for admission to a department conducted examination and for an initial license, a fee of one hundred fifteen dollars for each reexamination, a fee of one hundred thirty-five dollars for an initial license for persons not requiring admission to a department conducted examination, [and] a fee of two hundred ten dollars for each triennial registration period, [and] for additional authorization for the purpose of utilizing diagnostic pharmaceutical agents, a fee of sixty dollars, AND FOR CERTIFICATION TO USE OR PRESCRIBE ORAL THERAPEUTIC PHARMACEUTICAL AGENTS, A FEE OF ONE HUNDRED DOLLARS. § 14. This act shall take effect one year after it shall have become a law; provided that: (a) subdivision 13 of section 7101-a of the education law as added by section twelve of this act shall expire and be deemed repealed five years following the approval by the department of education of the initial certification course and examination pursuant to paragraph (c) of subdivision 4 of section 7101-a of the education law as added by section six of this act; (b) the commissioner of education shall notify the legislative bill drafting commission upon approval of the initial certification course S. 5235 7 and examination required in section six of this act in order that the commission may maintain an accurate and timely effective data base of the official text of the laws of the state of New York in furtherance of effectuating the provisions of section 44 of the legislative law and section 70-b of the public officers law; and (c) any rule or regulation necessary for the timely implementation of this act on its effective date shall be promulgated on or before such effective date.
co-Sponsors
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(D) Senate District
(R, C) 60th Senate District
(R, C, IP) 54th Senate District
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(R, C, IP) Senate District
(D, WF) 37th Senate District
(R, C, G, IP, SC) Senate District
(R, C) 58th Senate District
(R, C, IP) 62nd Senate District
(R, C, IP) Senate District
(R, C, IP) Senate District
(R, C, IP, RFM) Senate District
(D, IP) Senate District
(R, C, IP) Senate District
2017-S5235A (ACTIVE) - Details
2017-S5235A (ACTIVE) - Sponsor Memo
BILL NUMBER: S5235A SPONSOR: FUNKE TITLE OF BILL: An act to amend the education law, in relation to the use of oral medications by optometrists; and providing for the repeal of certain provisions upon expiration thereof PURPOSE OR GENERAL IDEA OF BILL: To authorize licensed optometrists who receive certification to prescribe certain oral medications. SUMMARY OF SPECIFIC PROVISIONS: Sections one and two amend paragraphs (e) and (f) of subdivision 1 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to clarify the use of certain topical therapeutic pharmaceu- tical agents which are already authorized for use by optometrists and are the standard of care in the treatment of patients for certain eye conditions.
Section three amends subdivision 1 of section 7101-a of the education law by adding a new paragraph (g) that sets forth the list of specific oral therapeutic pharmaceutical agents, including the generic equiv- alents of the listed drugs as provided, that optometrists, once certi- fied, will be authorized to prescribe and the conditions and limitations on the use of some drugs, including the referral of patients to licensed physicians as provided and the duration of certain prescriptions. Sections four and five amend paragraphs (a) and (b) of subdivision 4 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to replace the terms "phase one" and "phase two" with more descriptive terms related to the types of pharmaceutical agents optome- trists are authorized to use. These amendments are made throughout the bill. Section six amends subdivision 4 of section 7101-a of the education law by re-lettering paragraphs (c) and (d) of said subdivision paragraphs (d) and (e), and by adding a new paragraph (c). Paragraph (c) provides that in order for an optometrist to be authorized to prescribe oral medications, such optometrist must be certified to prescribe diagnostic pharmaceutical agents and topical therapeutic and therapeutic pharmaceu- tical agents for the treatment of glaucoma and ocular hypertension, have completed a forty-hour oral therapeutic pharmaceutical agent certif- ication course and have passed an examination acceptable to the state board of optometry. The course curriculum shall include instruction in pharmacology and drug interaction in treating ocular disease and shall be taught through clinical case scenarios and emphasize clinical deci- sion-making. Optometrists must pass the examination within five years of the department's approval of the initial certification course or the initial examination, whichever is later. Optometrists would be required to retake and complete the certification course if they fail to pass the examination after three attempts, and then retake the examination. Further, optometrists may be authorized to retake the examination and to become certified beyond the five year timeframe upon application by the optometrist and a determination of good cause shown by the commissioner. The initial, and any subsequent, curriculum and examination shall be subject to review and approval by SED. Optometrists who graduated from an accredited college of optometry after January 1, 2007 and have passed the National Board of Examiners in Optometry or another examination will be eligible for certification and will not be required to complete the course or pass the examination. Section seven amends subdivision 5 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to specify that the suspension of certification for the use of topical therapeutic agents applies to an optometrist who fails to receive certification for thera- peutic pharmaceutical agents for treatment of glaucoma and ocular hyper- tension. Section eight amends the subdivision heading of subdivision 6 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995. Section nine amends subdivision 7 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to require optome- trists certified to use oral therapeutic pharmaceutical agents to complete an additional minimum of thirty-nine hours of continuing educa- tion related to systemic disease and therapeutic treatment, in addition to the minimum thirty-six hours of continuing education requirement, per triennial registration period. Section ten amends the subdivision heading and amends subparagraph (i) of paragraph (a) of subdivision 8 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to clarify the appli- cability of a separate notice to patients regarding the use of certain topical medications. Section eleven amends subdivision 10 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to provide that opto- metrists certified to use and prescribe oral medications shall be authorized to use and prescribe those oral medications that are FDA approved and commercially available. Prescribing oral medications must be in compliance with all safety information and side-effect and warning advisories contained in the most current physicians' desk reference. In addition, optometrists certified to prescribe topical and oral therapeu- tic pharmaceutical agents shall be authorized to use and recommend all nonprescription medications, whether intended for topical or oral use, appropriate for the treatment of the eye and adnexa. Section twelve amends subdivision 8 of section 7104 of the education law, as amended by chapter 517 of the laws of 1995, to provide that applicants for a license as an optometrist shall pay an additional fee of two-hundred fifty dollars for certification to use or prescribe oral therapeutic pharmaceutical agents. Section thirteen amends the unconsolidated law to require optometrists certified to prescribe oral therapeutic pharmaceutical agents to submit a form to SED on a quarterly basis detailing the optometrist's license number and national provider identifier, whether any oral prescriptions were issued and, when used, to include information related to the dosage of the agent, the date of the prescription, the patient's diagnosis, and whether a referral to a physician was made, if required. The require- ments set forth in subdivision (2) of this section shall remain in effect from the approval by SED of the initial oral therapeutic pharma- ceutical agent certification course and examination and shall expire five years after such date. The Commissioner of Education will appoint a committee comprised of one pharmacist, one representative each on behalf of organized ophthalmology and optometry, and a public health expert who is neither an ophthalmologist nor an optometrist, to review submitted forms and cross-check against any available databases where prescriptions by optometrists are recorded to determine compliance by optometrists related to their use and prescription of oral therapeutic pharmaceutical agents and to identify any necessary enhancements to the curriculum provided for in this section and other educational materials and to assist in ensuring patient safety. If evidence of non-compliance is found, the committee shall refer such information to the Commissioner of Education and the State Office of Professions for investigation and, if applicable, disciplinary action. The bill affirms that the responsi- bilities of the committee shall not limit SED's authority to review, investigate and refer matters related to the professional conduct of a licensed provider. If one or more databases containing electronic pres- criber information relating to oral therapeutic pharmaceutical agents prescribed or used by optometrists become available, and the Commission- er of Education determines and advises optometrists that quarterly reports are no longer necessary, then the committee shall review the database and ascertain the prescribing information for all optometrists consistent with this section. Section fourteen provides the effective date. JUSTIFICATION: In 1995, the Legislature enacted a law authorizing a specialty certif- ication for optometrists with training and experience to use topically applied therapeutic pharmaceutical agents for the treatment or prevention of ocular disease. By law, such certified optometrists are required to be held to the same standard of care in the diagnosis and treatment of patients, including the use of pharmaceutical agents, as the degree of skill and proficiency commonly exercised by a physician. In the years since the 1995 legislation was enacted, New Yorkers have enjoyed enhanced access to and a higher quality of primary eye care services provided by optometrists who meet the qualifications set forth in the law. This new legislation extends the 1995 legislation another modest step by allowing optometrists who complete additional coursework and pass an examination to become certified to prescribe for their patients certain oral medications for the treatment of eye disease. Currently, 48 states and the District of Columbia allow optometrists to prescribe and use a range of oral pharmaceutical agents for ocular conditions.. This law will put New York on a parallel path with other states. Optometric students at SUNY College of Optometry are educated and trained in the prescription and use of these medications. The enact- ment of this legislation will provide optometrists the authority to treat patients with a limited number of medications for certain ocular diseases and will ensure that the prescribing optometrists are fully prepared to fulfill this responsibility. This bill would limit the number and types of oral medications that may be prescribed, promote greater coordination in care with a patient's physician, enhance the educational and training requirements for optome- trists, limit the duration of certain oral drugs that are authorized to be used, and provide additional oversight of oral prescription practices by optometrists. The bill would, among other provisions, require optometrists who wish to prescribe and use oral medications to take a certification course and pass an examination approved by the Education Department. The applicant would be required to pass the examination within five years of the department's approval of the initial certification course or the initial examination, whichever is later, but would be permitted to retake the exam and to become certified after that timeframe upon the Commissioner of Education's determination of good cause which would include circum- stances related to an applicant's disability, illness including episodic and chronic and persistent conditions, limited English proficiency, adverse personal circumstances, or other circumstances as determined by the commissioner. PRIOR LEGISLATIVE HISTORY: Similar to A.6751, 2017 referred to higher education. Same as S.5235, 2017 referred to higher education. A.9961-A, 2016 referred to higher education. Same as S.7440-A, 2016 passed Senate. Similar to A.2803, 2015 and 2016 referred to higher education. Similar to A.2192-A, 2013 and 2014 referred to higher education. Same as S.7678-A, 2013 and 2014 referred to higher education. Similar to A.363-B, 2011 and 2012 referred to higher education. Same as S.30277B, 2011 and 201.2 referred to higher education. Similar to A.3718, 2009 and 2010 referred to higher education. Same as S.2667, 2009 and 2010 referred to higher education. Similar to A.8001, 2007 and 2008 referred to higher education. Same as S.4519, 2007-2008 referred to higher education. Similar to A.4329A, 2005 and 2006 referred to higher education. Same as S.2719-A, 2005 and 2006. Similar to A.7223, 2003 and 2004 referred to higher education. Same as S.2761, 2003 and 2004 referred to higher education. Similar to A.8814, 2001 and 2002 referred to higher education. Same as S.4482, 2001 and 2002 referred to higher education. FISCAL IMPLICATION: None to the State. EFFECTIVE DATE: This act shall take effect eighteen months after it shall have become a law; provided that (i) the unconsolidated law added by section thirteen of the act shall expire and be deemed repealed five years following the approval by the Department of Education of the initial certification course and examination pursuant to paragraph (c) of subdivision 4 of section 7101-a of the education law as added by section six of the act, (ii) the Commissioner of Education shall notify the legislative bill drafting commission upon approval of the initial certification course and examination required in section 6 of this act, and (iii) any rule or regulation necessary for the timely implementation of this act on its effective date shall be promulgated on or before such effective date.
2017-S5235A (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 5235--A 2017-2018 Regular Sessions I N S E N A T E March 16, 2017 ___________ Introduced by Sens. FUNKE, ADDABBO, AKSHAR, ALCANTARA, GALLIVAN, LITTLE, MARCHIONE, MURPHY, O'MARA, ORTT, RITCHIE, SERINO, SEWARD, VALESKY, YOUNG -- read twice and ordered printed, and when printed to be committed to the Committee on Higher Education -- recommitted to the Committee on Higher Education in accordance with Senate Rule 6, sec. 8 -- 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; and providing for the repeal of certain provisions upon expiration thereof THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph (e) of subdivision 1 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: (e) [Phase one] TOPICAL therapeutic pharmaceutical agents. [Phase one] TOPICAL THERAPEUTIC pharmaceutical agents shall mean those drugs which shall be limited to topical application to the surface of the eye for therapeutic purposes and shall be limited to: (i) antibiotic/antimicrobials; (ii) decongestants/anti-allergenics; (iii) non-steroidal anti-inflammatory agents; (iv) steroidal anti-inflammatory agents; (v) antiviral agents; (vi) hyperosmotic/hypertonic agents; (vii) cycloplegics; (viii) artificial tears and lubricants; AND (IX) IMMUNOSUPPRESSIVE AGENTS. § 2. Paragraph (f) of subdivision 1 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted.
LBD04288-13-7 S. 5235--A 2 (f) [Phase two therapeutic] THERAPEUTIC pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION. [Phase two] THERAPEUTIC pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION shall mean those drugs which shall be limited to topical application to the surface of the eye and shall be limited to: (i) beta blockers; (ii) alpha agonists; (iii) direct acting cholinergic agents; (IV) PROSTAGLANDIN ANALOGS; AND (V) CARBONIC ANHYDRASE INHIBITORS. § 3. Subdivision 1 of section 7101-a of the education law is amended by adding a new paragraph (g) to read as follows: (G) ORAL THERAPEUTIC PHARMACEUTICAL AGENTS. ORAL THERAPEUTIC PHARMA- CEUTICAL AGENTS SHALL MEAN THOSE ORALLY ADMINISTERED DRUGS USED FOR THERAPEUTIC PURPOSES SOLELY FOR THE TREATMENT OF DISEASES OF THE EYE AND ADNEXA AND SHALL BE LIMITED TO: (I) THE FOLLOWING ANTIBIOTICS, INCLUDING, WHERE APPLICABLE, THE GENER- IC EQUIVALENT OF ANY OF THE LISTED DRUGS: (1) AUGMENTIN; (2) KEFLEX; (3) AZITHROMYCIN; (4) BACTRIM; (5) DOXYCYCLINE; AND (6) TETRACYCLINE; (II) THE FOLLOWING DECONGESTANTS/ANTI-ALLERGENIC/ANTIHISTAMINES, INCLUDING THE GENERIC EQUIVALENTS OF THE LISTED DRUGS: (1) CLARINEX; (2) XYZAL; AND (3) SINGULAIR; (III) THE FOLLOWING ANTIGLAUCOMA AGENTS, INCLUDING THE GENERIC EQUIV- ALENTS OF SUCH AGENTS, USED FOR THE MANAGEMENT OF ACUTE INCREASES IN INTRAOCULAR PRESSURE; PROVIDED, HOWEVER, AN OPTOMETRIST MAY USE OR PRESCRIBE A MAXIMUM OF ONE TWENTY-FOUR HOUR PRESCRIPTION AND SHALL IMME- DIATELY REFER THE PATIENT TO A LICENSED PHYSICIAN SPECIALIZING IN DISEASES OF THE EYE: (1) DIAMOX; AND (2) NEPTAZANE; (IV) THE FOLLOWING ANTIVIRAL AGENTS, INCLUDING THE GENERIC EQUIVALENTS OF SUCH AGENTS, USED FOR HERPES ZOSTER OPHTHALMICUS; PROVIDED AN OPTOME- TRIST SHALL USE OR PRESCRIBE IN MAXIMUM, SEVEN-DAY PRESCRIPTIONS; PROVIDED, HOWEVER, IF A PATIENT IS DIAGNOSED WITH HERPES ZOSTER OPHTHAL- MICUS AND HAS NOT ALREADY BEEN EXAMINED BY A PRIMARY CARE PHYSICIAN OR OTHER APPROPRIATE PHYSICIAN FOR SUCH VIRAL CONDITION, AN OPTOMETRIST SHALL REFER THE PATIENT TO A LICENSED PRIMARY CARE PHYSICIAN, LICENSED PHYSICIAN SPECIALIZING IN DISEASES OF THE EYE, OR OTHER APPROPRIATE PHYSICIAN WITHIN THREE DAYS OF SUCH DIAGNOSIS: (1) VALACYCLOVIR; AND (2) ACYCLOVIR; AND (V) THE FOLLOWING NON-STEROIDAL ANTI-INFLAMMATORY AGENTS: (1) COX-2 INHIBITORS; (2) IBUPROFEN; AND (3) NAPROXEN. § 4. The subdivision heading and paragraph (a) of subdivision 4 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, are amended to read as follows: S. 5235--A 3 [Phase one] TOPICAL therapeutic pharmaceutical agents. (a) Before using or prescribing [phase one] TOPICAL therapeutic pharmaceutical agents, each optometrist shall have completed at least three hundred hours of clinical training in the diagnosis, treatment and management of patients with ocular disease other than glaucoma and ocular hyperten- sion, not fewer than twenty-five hours of such training shall have been completed subsequent to June thirtieth, nineteen hundred ninety-three and additionally shall either have taken and successfully passed the treatment and management of ocular diseases portion of the National Board of Examiners in Optometry test or have taken and successfully passed an examination acceptable to the board. § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: (b) Before using or prescribing [phase two] therapeutic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION, an optometrist must be certified for diagnostic and [phase one] TOPICAL therapeutic agents and have completed an additional one hundred hours of clinical training in the diagnosis, treatment and management of patients with glaucoma and ocular hypertension, not fewer than twenty-five hours of such training shall have been completed subsequent to July first, nine- teen hundred ninety-four, and shall have taken and successfully passed an oral or written examination acceptable by the board. § 6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of the education law are relettered paragraphs (d) and (e) and a new paragraph (c) is added to read as follows: (C) BEFORE USING OR PRESCRIBING ORAL THERAPEUTIC PHARMACEUTICAL AGENTS, AN OPTOMETRIST MUST BE CERTIFIED TO PRESCRIBE DIAGNOSTIC PHARMA- CEUTICAL AGENTS AND TOPICAL THERAPEUTIC AND THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION, HAVE COMPLETED AN ORAL THERAPEUTIC PHARMACEUTICAL AGENT CERTIFICATION COURSE AND HAVE PASSED AN EXAMINATION WITHIN FIVE YEARS OF THE DEPARTMENT'S APPROVAL OF THE INITIAL CERTIFICATION COURSE OR THE INITIAL EXAMINATION, WHICHEVER IS LATER. (I) THE CURRICULUM FOR THE COURSE SHALL INCLUDE, BUT NOT BE LIMITED TO, INSTRUCTION IN PHARMACOLOGY AND DRUG INTERACTION IN TREATING OCULAR DISEASE AND BE TAUGHT THROUGH CLINICAL CASE SCENARIOS AND EMPHASIZE CLINICAL DECISION MAKING AND SHALL BE NO LESS THAN FORTY HOURS, OF WHICH NO LESS THAN TWENTY-FOUR HOURS SHALL BE LIVE INSTRUCTION. (II) SUCH COURSE SHALL QUALIFY TOWARDS MEETING THE CONTINUING EDUCA- TION PER TRIENNIAL REGISTRATION REQUIREMENT PURSUANT TO SUBDIVISION SEVEN OF THIS SECTION. (III) THE EXAMINATION SHALL TEST THE KNOWLEDGE OF MATERIALS IN THE CURRICULUM AND REFLECT THE PROVISIONS OF PARAGRAPH (G) OF SUBDIVISION ONE OF THIS SECTION, AND SHALL BE ACCEPTABLE TO THE DEPARTMENT. IF AN OPTOMETRIST FAILS TO PASS THE EXAMINATION, SUCH OPTOMETRIST MAY RETAKE THE EXAMINATION; PROVIDED, HOWEVER, THAT IF AN OPTOMETRIST FAILS TO PASS THE EXAMINATION AFTER THREE ATTEMPTS, SUCH OPTOMETRIST MUST AGAIN COMPLETE THE CERTIFICATION COURSE IN ORDER TO RETAKE THE EXAMINATION. AN OPTOMETRIST SHALL BE REQUIRED TO COMPLETE THE CERTIFICATION COURSE AFTER EACH SUBSEQUENT FAILURE TO PASS THE EXAMINATION THREE TIMES. IF AN OPTO- METRIST REQUIRES MORE TIME TO PASS THE EXAMINATION AND TO BECOME CERTI- FIED THAN THE FIVE-YEAR PERIOD PROVIDED FOR IN THIS PARAGRAPH, SUCH OPTOMETRIST MAY BE AUTHORIZED TO RETAKE THE EXAMINATION AND TO BECOME CERTIFIED BEYOND SUCH PERIOD UPON APPLICATION BY THE OPTOMETRIST AND A SHOWING OF GOOD CAUSE AS MAY BE ACCEPTABLE TO THE COMMISSIONER. S. 5235--A 4 (IV) THE INITIAL, AND ANY SUBSEQUENT, CURRICULUM AND EXAMINATION SHALL BE SUBJECT TO REVIEW AND APPROVAL BY THE DEPARTMENT. (V) THE REQUIREMENT FOR THE ORAL THERAPEUTIC PHARMACEUTICAL AGENT CERTIFICATION COURSE AND EXAMINATION SHALL NOT APPLY TO THOSE OPTOME- TRISTS WHO GRADUATED FROM AN ACCREDITED COLLEGE OF OPTOMETRY SUBSEQUENT TO JANUARY FIRST, TWO THOUSAND SEVEN AND HAVE TAKEN AND SUCCESSFULLY PASSED THE NATIONAL BOARD OF EXAMINERS IN OPTOMETRY TEST OR AN EXAMINA- TION ACCEPTABLE TO THE DEPARTMENT. § 7. Subdivision 5 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: 5. Suspension of certification. The department shall suspend the certification for the use and prescribing of [phase one] TOPICAL thera- peutic agents of any optometrist who fails to receive certification for [phase two] therapeutic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION within three years of having been certified for [phase one] TOPICAL therapeutic pharmaceutical agents. § 8. The subdivision heading of subdivision 6 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: Consultation WITH USE OF CERTAIN TOPICAL THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION. § 9. Subdivision 7 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: 7. Continuing education. Each optometrist certified to use [phase one or phase two] TOPICAL THERAPEUTIC PHARMACEUTICAL AGENTS AND therapeutic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION, shall complete a minimum of thirty-six hours of continuing education IN THE AREA OF OCULAR DISEASE AND PHARMACOLOGY per triennial registration period. [The education shall be in the area of ocular disease and phar- macology and may include both didactic and clinical components.] EACH OPTOMETRIST CERTIFIED TO USE ORAL THERAPEUTIC PHARMACEUTICAL AGENTS SHALL, IN ADDITION TO THE MINIMUM THIRTY-SIX HOURS OF CONTINUING EDUCA- TION PROVIDED FOR IN THIS SUBDIVISION, COMPLETE AN ADDITIONAL MINIMUM OF THIRTY-NINE HOURS OF CONTINUING EDUCATION RELATED TO SYSTEMIC DISEASE AND THERAPEUTIC TREATMENT PER TRIENNIAL REGISTRATION PERIOD. Such educa- tional programs MAY INCLUDE BOTH DIDACTIC AND CLINICAL COMPONENTS AND shall be approved in advance by the department and evidence of the completion of this requirement shall be submitted with each application for license renewal as required by section sixty-five hundred two of this chapter. § 10. The subdivision heading and subparagraph (i) of paragraph (a) of subdivision 8 of section 7101-a of the education law, as added by chap- ter 517 of the laws of 1995, are amended to read as follows: Notice to patient WITH THE USE OR PRESCRIPTION OF TOPICAL THERAPEUTIC PHARMACEUTICAL AGENTS AND THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREAT- MENT OF GLAUCOMA AND OCULAR HYPERTENSION. (i) An optometrist prescribing TOPICAL steroids or antiviral medica- tion shall inform each patient that in the event the condition does not improve within five days, a physician of the patient's choice will be notified. § 11. Subdivision 10 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, is amended to read as follows: 10. Pharmaceutical agents. Optometrists who have been approved and certified by the department shall be permitted to use the following drugs: (a) Diagnostic pharmaceuticals. S. 5235--A 5 (b) Those optometrists having been certified for [phase one] TOPICAL therapeutic pharmaceutical agents shall be authorized [(i) to use and recommend all nonprescription medications appropriate for ocular disease whether intended for topical or oral use; and (ii)] to use and prescribe all [phase one] TOPICAL therapeutic pharmaceutical agents SPECIFIED IN PARAGRAPH (E) OF SUBDIVISION ONE OF THIS SECTION, which are FDA approved and commercially available FOR TOPICAL USE. In the event an optometrist treats a patient with topical antiviral or steroidal drugs and the patient's condition either fails to improve or worsens within five days, the optometrist shall notify a physician designated by the patient or, if none, by the treating optometrist. (c) Those optometrists having been certified for [phase two] therapeu- tic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTEN- SION shall be authorized to use and prescribe [phase two] therapeutic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION SPECIFIED IN PARAGRAPH (F) OF SUBDIVISION ONE OF THIS SECTION, which are FDA approved and commercially available. (D) THOSE OPTOMETRISTS HAVING BEEN CERTIFIED FOR ORAL THERAPEUTIC PHARMACEUTICAL AGENTS SHALL BE AUTHORIZED TO USE AND PRESCRIBE ORAL THERAPEUTIC PHARMACEUTICAL AGENTS SPECIFIED IN PARAGRAPH (G) OF SUBDIVI- SION ONE OF THIS SECTION, WHICH ARE FDA APPROVED AND COMMERCIALLY AVAIL- ABLE AND SHALL COMPLY WITH ALL SAFETY INFORMATION AND SIDE-EFFECT AND WARNING ADVISORIES CONTAINED IN THE MOST CURRENT PHYSICIANS' DESK REFER- ENCE. (E) THOSE OPTOMETRISTS HAVING BEEN CERTIFIED FOR TOPICAL THERAPEUTIC PHARMACEUTICAL AGENTS, THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION OR ORAL THERAPEUTIC PHARMACEUTICAL AGENTS SHALL BE AUTHORIZED TO USE AND RECOMMEND ALL NONPRESCRIPTION MEDICATIONS, WHETHER INTENDED FOR TOPICAL OR ORAL USE, APPROPRIATE FOR THE TREATMENT OF THE EYE AND ADNEXA. § 12. Subdivision 8 of section 7104 of the education law, as amended by chapter 517 of the laws of 1995, is amended to read as follows: (8) Fees: pay a fee of two hundred twenty dollars to the department for admission to a department conducted examination and for an initial license, a fee of one hundred fifteen dollars for each reexamination, a fee of one hundred thirty-five dollars for an initial license for persons not requiring admission to a department conducted examination, [and] a fee of two hundred ten dollars for each triennial registration period, [and] for additional authorization for the purpose of utilizing diagnostic pharmaceutical agents, a fee of sixty dollars, AND FOR CERTIFICATION TO USE OR PRESCRIBE ORAL THERAPEUTIC PHARMACEUTICAL AGENTS, A FEE OF TWO HUNDRED FIFTY DOLLARS. § 13. Oral therapeutic pharmaceutical agent implementation review. 1. For purposes of this section, the term "commissioner" shall mean the commissioner of the state education department; and the term "depart- ment" shall mean the state education department. 2. Each optometrist certified to use oral therapeutic pharmaceutical agents pursuant to paragraph (c) of subdivision four of section 7101-a of the education law shall provide the department with information, on a form prescribed by the commissioner, related to the prescription or use of oral therapeutic pharmaceutical agents provided for in section 7101-a of the education law. Such information shall include the optometrist's license number and the national provider identifier as established by the centers for medicare and medicaid services, whether no oral prescriptions have been issued and in the event that oral prescriptions have been issued, then the following information shall be required: the S. 5235--A 6 prescribed or used oral therapeutic pharmaceutical agent, the dosage of such agent, the date of the prescription, the diagnosis of the patient for which the agent was prescribed or used, and whether a referral was made in accordance with paragraph (g) of subdivision one of section 7101-a of the education law. Such information shall not include any patient identifying information and must otherwise be in compliance with all state and federal requirements related to protected health informa- tion. Each form shall be submitted by mail or electronic means to the department on a quarterly basis. If a database of all oral therapeutic pharmaceutical agents prescribed or used by optometrists is, or becomes, available to the committee provided for in this act, then optometrists shall be advised by the commissioner that quarterly reporting forms will no longer be required. The requirements of this section shall remain in effect for five years following approval by the department of the initial oral therapeutic pharmaceutical agent certification course and examination pursuant to paragraph (c) of subdivision four of section 7101-a of the education law, after which time these requirements shall expire and no longer have effect. 3. The commissioner shall appoint a committee to advise and assist the commissioner in evaluating compliance with the provisions of section 7101-a of the education law and to identify any necessary enhancements to the curriculum provided for in such section and other educational materials and to assist in ensuring patient safety. The committee shall consist of one pharmacist, one optometrist upon the recommendation of a statewide professional organization consisting of optometrists, one ophthalmologist upon the recommendation of a statewide professional organization consisting of ophthalmologists, and one expert in the field of public health who shall be designated as chair by the commissioner in consultation with the commissioner of the department of health and who shall be neither an ophthalmologist nor an optometrist. 4. The commissioner shall submit each form received pursuant to this section to the committee, except as otherwise provided in this subdivi- sion. The committee shall review the forms and shall randomly cross- check such submissions with a publicly available or other database containing electronic prescriber information. Should a database of all oral therapeutic pharmaceutical agents prescribed or used by optome- trists pursuant to section 7101-a of the education law become available, and the commissioner determines and advises optometrists that quarterly reports are no longer necessary, then the committee shall review the database and ascertain the prescribing information for all optometrists consistent with section 7101-a of the education law. The committee shall advise the commissioner as to compliance with the provisions of section 7101-a of the education law for the purpose of evaluating compliance with the provisions of section 7101-a of the education law including the applicable referrals and dosing limitations and to identi- fy any necessary enhancements to the curriculum provided for in para- graph (c) of subdivision 4 of section 7101-a of the education law and other educational materials and to assist in ensuring patient safety. Upon finding evidence of non-compliance by any optometrist, the commit- tee shall refer such information to the commissioner and to the office of professions within the department for investigation and, if applica- ble, disciplinary action. Nothing in this subdivision is intended to modify or otherwise limit the department's authority or discretion to review, investigate and refer matters related to the professional conduct of a licensed provider. S. 5235--A 7 § 14. This act shall take effect eighteen months after it shall have become a law; provided that: (a) section thirteen of this act shall expire and be deemed repealed five years following the approval by the department of education of the initial certification course or the initial examination, whichever is later, pursuant to paragraph (c) of subdivision 4 of section 7101-a of the education law as added by section six of this act; (b) the commissioner of education shall notify the legislative bill drafting commission upon approval of the initial certification course and examination required in section six of this act in order that the commission may maintain an accurate and timely effective data base of the official text of the laws of the state of New York in furtherance of effectuating the provisions of section 44 of the legislative law and section 70-b of the public officers law; and (c) any rule or regulation necessary for the timely implementation of this act on its effective date shall be promulgated on or before such effective date.
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