Relates to the use of oral medications by optometrists

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 pharmaceutical agents for the treatment of glaucoma and ocular hypertension, have completed a forty-hour oral therapeutic pharmaceutical agent certification course and have passed an examination, with a curriculum and examination 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 may take the examination up to three times, provided that an optometrist may be authorized to retake the examination beyond such maximum number 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, 2006 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 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. 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 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.

Prior legislative history

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.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 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.