Authorizes optometrists to prescribe certain drugs that may be used for therapeutic purposes and taken orally

Summary of specific provisions

Section one amends subdivision 1 of section 7101-a of the education law by adding a new paragraph (g) that provides the definition of phase three therapeutic pharmaceutical agents, to include those pharmaceutical agents listed and limitations on the duration of some prescriptions.

Section two 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 optometrists must first be certified to prescribe diagnostic pharmaceutical agents and phase one and phase two therapeutic pharmaceutical agents and complete a thirty hour phase three therapeutic pharmaceutical agent certification course with a curriculum developed by a New York state-accredited college of optometry in collaboration with an accredited medical school and approved by the education department, before using or prescribing phase three pharmaceutical agents. The curriculum shall include instruction in pharmacology and drug interaction and be taught through clinical case scenarios and emphasize clinical decision making. The thirty hour course requirement shall not apply to certain specified optometrists.

Section three amends subdivision 5 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, by providing that the department shall suspend the certification for the use and prescribing of phase one and phase two therapeutic agents of any optometrist who fails to receive certification for phase three therapeutic pharmaceutical agents within three years of approval by the department of the thirty-hour certification course.

Section four amends the opening paragraph of subdivision 6 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, and adds new subdivisions 6-a and 6-b to require that an optometrist document, as soon as practicable, in the patient's record the prescription or use of an oral medication. In addition, within 72 hours of prescribing or using an oral medication, an optometrist shall notify the patient's primary care practitioner and document such notification concerning the agent used or prescribed, the dose, frequency of use and duration of prescription. The bill would also require that if a patient's condition does not result in an adequate clinical response with the use of an oral medication, an optometrist shall consult with the patient's primary care practitioner as soon as clinically prudent.

Section five amends subdivision 7 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, by providing that at least six hours of the thirty-six hours of continuing education that is required per triennial registration period shall relate specifically to systemic drug use and interaction.

Section six amends the opening paragraph of subdivision 8 of section 7101-a, 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 seven 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 for phase one, phase two or phase three 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 eight amends subdivision 12 of section 7101-a of the education law, as added by chapter 517 of the laws of 1995, to clarify that the commissioner of health shall recommend to the commissioner of education additions or deletions to the list of approved categories of medications used or prescribed by optometrists which are consistent with the standard of care in the diagnosis and treatment of diseases of the eye and adnexa.

Section nine 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 diagnosis, use of such agents, and treatment as that 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 legislation. This new legislation extends the 1995 legislation another modest step by permitting optometrists to prescribe for their patients oral medications for the treatment of eye disease in some cases, and permit optometrists (who satisfy certain continuing education requirements) to prescribe oral medications solely in the context of treating eye disease.

The bill would further establish consistency over the categories of diagnostic, therapeutic and orals drugs that optometrists shall be authorized to use by providing that the Commissioner of Health shall recommend additions to or deletions from such categories based on whether they are the standard of care for the diagnosis and treatment of eye disease and adnexa.

Currently, 48 states and the District of Columbia allow optometrists to prescribe and use a range of oral pharmaceutical agents for ocular conditions. This bill mirrors certain provisions and restrictions in many of those other states to authorize the minimum authority needed for optometrists to appropriately treat their patients.

Optometric students at SUNY College of Optometry and optometric schools across the country are required to be thoroughly educated and trained in the prescription and use of these medications. The enactment of this legislation will provide New Yorkers access to the most effective and appropriate medications that are necessary in the treatment of ocular diseases and will ensure that the prescribing optometrist is fully prepared to fulfill this responsibility. This bill is significantly more narrow than previously introduced legislation in that it would conform New York's statute with that of other states and improve patient care by promoting greater communication among a patient's health care providers, enhancing the educational and training requirements for optometrists, and limiting the duration of certain oral drugs that are authorized to be used.

Prior legislative history

Similar to A.363-B, 2011 and 2012 referred to higher education. Same as S.3027-B, 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 on the one hundred twentieth day after it shall have become a law; provided that 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.