STATE OF NEW YORK
________________________________________________________________________
1519
2021-2022 Regular Sessions
IN SENATE
January 12, 2021
___________
Introduced by Sen. BAILEY -- 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
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
6 shall be limited to topical application to the surface of the eye for
7 therapeutic purposes and shall be limited to:
8 (i) antibiotic/antimicrobials;
9 (ii) decongestants/anti-allergenics;
10 (iii) non-steroidal anti-inflammatory agents;
11 (iv) steroidal anti-inflammatory agents;
12 (v) antiviral agents;
13 (vi) hyperosmotic/hypertonic agents;
14 (vii) cycloplegics;
15 (viii) artificial tears and lubricants; and
16 (ix) immunosuppressive agents.
17 § 2. Paragraph (f) of subdivision 1 of section 7101-a of the education
18 law, as added by chapter 517 of the laws of 1995, is amended to read as
19 follows:
20 (f) [Phase two therapeutic] Therapeutic pharmaceutical agents for
21 treatment of glaucoma and ocular hypertension. [Phase two] Therapeutic
22 pharmaceutical agents for treatment of glaucoma and ocular hypertension
23 shall mean those drugs which shall be limited to topical application to
24 the surface of the eye and shall be limited to:
25 (i) beta blockers;
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02016-01-1
S. 1519 2
1 (ii) alpha agonists;
2 (iii) direct acting cholinergic agents;
3 (iv) prostaglandin analogs; and
4 (v) carbonic anhydrase inhibitors.
5 § 3. Subdivision 1 of section 7101-a of the education law is amended
6 by adding a new paragraph (g) to read as follows:
7 (g) Oral therapeutic pharmaceutical agents. Oral therapeutic pharma-
8 ceutical agents shall mean those orally administered drugs used for
9 therapeutic purposes solely for the treatment of diseases of the eye and
10 adnexa and shall be limited to:
11 (i) the following antibiotics:
12 (1) amoxicillin/clavulanate potassium;
13 (2) cephalexin;
14 (3) azithromycin;
15 (4) sulfamethoxazole/trimethoprim;
16 (5) doxycycline; and
17 (6) tetracycline;
18 (ii) the following antiglaucoma agents used for the management of
19 acute increases in intraocular pressure; provided, however, an optome-
20 trist may use or prescribe a maximum of one twenty-four hour
21 prescription and shall immediately refer the patient to a licensed
22 physician specializing in diseases of the eye:
23 (1) acetazolamide; and
24 (2) methazolamide; and
25 (iii) the following antiviral agents used for herpes zoster ophthalmi-
26 cus; provided an optometrist shall use or prescribe in maximum, one
27 seven-day prescription; provided, however, if a patient is diagnosed
28 with herpes zoster ophthalmicus and has not already been examined by a
29 primary care physician or other appropriate physician for such viral
30 condition, an optometrist shall refer the patient to a licensed primary
31 care physician, licensed physician specializing in diseases of the eye,
32 or other appropriate physician within three days of such diagnosis:
33 (1) valacyclovir; and
34 (2) acyclovir.
35 § 4. The subdivision heading and paragraph (a) of subdivision 4 of
36 section 7101-a of the education law, as added by chapter 517 of the laws
37 of 1995, are amended to read as follows:
38 [Phase one] Topical therapeutic pharmaceutical agents. (a) Before
39 using or prescribing [phase one] topical therapeutic pharmaceutical
40 agents, each optometrist shall have completed at least three hundred
41 hours of clinical training in the diagnosis, treatment and management of
42 patients with ocular disease other than glaucoma and ocular hyperten-
43 sion, not fewer than twenty-five hours of such training shall have been
44 completed subsequent to June thirtieth, nineteen hundred ninety-three
45 and additionally shall either have taken and successfully passed the
46 treatment and management of ocular diseases portion of the National
47 Board of Examiners in Optometry test or have taken and successfully
48 passed an examination acceptable to the board.
49 § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education
50 law, as added by chapter 517 of the laws of 1995, is amended to read as
51 follows:
52 (b) Before using or prescribing [phase two] therapeutic pharmaceutical
53 agents for treatment of glaucoma and ocular hypertension, an optometrist
54 must be certified for diagnostic and [phase one] topical therapeutic
55 agents and have completed an additional one hundred hours of clinical
56 training in the diagnosis, treatment and management of patients with
S. 1519 3
1 glaucoma and ocular hypertension, not fewer than twenty-five hours of
2 such training shall have been completed subsequent to July first, nine-
3 teen hundred ninety-four, and shall have taken and successfully passed
4 an oral or written examination acceptable by the board.
5 § 6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of the
6 education law are relettered paragraphs (d) and (e) and a new paragraph
7 (c) is added to read as follows:
8 (c) Before using or prescribing oral therapeutic pharmaceutical
9 agents, an optometrist must be certified to prescribe diagnostic pharma-
10 ceutical agents and topical therapeutic and therapeutic pharmaceutical
11 agents for treatment of glaucoma and ocular hypertension, have completed
12 an oral therapeutic pharmaceutical agent certification course and have
13 passed an examination within five years of the department's approval of
14 the initial certification course or the initial examination, whichever
15 is later provided, however, an optometrist who has commenced the oral
16 therapeutic pharmaceutical agent certification course within the five
17 year time period but has not yet passed an examination shall be allowed
18 to take such examination and become certified after the five year time
19 period provided for in this paragraph has ended.
20 (i) The curriculum for the oral therapeutic pharmaceutical agent
21 certification course shall include, but not be limited to, instruction
22 in pharmacology and drug interaction in treating ocular disease and be
23 taught through clinical case scenarios and emphasize clinical decision
24 making and shall be no less than forty hours, of which no less than
25 twenty-four hours shall be live instruction.
26 (ii) Such course shall qualify towards meeting the continuing educa-
27 tion per triennial registration requirement pursuant to subdivision
28 seven of this section.
29 (iii) The examination shall assess the knowledge of materials in the
30 curriculum and reflect the oral therapeutic pharmaceutical agents
31 described in paragraph (g) of subdivision one of this section, and shall
32 be acceptable to the department.
33 (iv) The initial, and any subsequent, curriculum and examination shall
34 be subject to review and approval by the department.
35 (v) The requirement for the oral therapeutic pharmaceutical agent
36 certification course and examination shall not apply to those optome-
37 trists who graduated from an accredited college of optometry subsequent
38 to January first, two thousand twenty-two and have taken and successful-
39 ly passed the National Board of Examiners in Optometry examination or an
40 examination acceptable to the department.
41 § 7. Subdivision 5 of section 7101-a of the education law, as added by
42 chapter 517 of the laws of 1995, is amended to read as follows:
43 5. Suspension of certification. The department shall suspend the
44 certification for the use and prescribing of [phase one] topical thera-
45 peutic agents of any optometrist who fails to receive certification for
46 [phase two] therapeutic pharmaceutical agents for treatment of glaucoma
47 and ocular hypertension within three years of having been certified for
48 [phase one] topical therapeutic pharmaceutical agents.
49 § 8. The subdivision heading of subdivision 6 of section 7101-a of the
50 education law, as added by chapter 517 of the laws of 1995, is amended
51 to read as follows:
52 Consultation with use of certain topical therapeutic pharmaceutical
53 agents for treatment of glaucoma and ocular hypertension.
54 § 9. Subdivision 7 of section 7101-a of the education law, as added by
55 chapter 517 of the laws of 1995, is amended to read as follows:
S. 1519 4
1 7. Continuing education. (a) Each optometrist certified to use [phase
2 one or phase two] topical therapeutic pharmaceutical agents and thera-
3 peutic pharmaceutical agents for treatment of glaucoma and ocular hyper-
4 tension, shall complete a minimum of thirty-six hours of continuing
5 education in the area of ocular disease and pharmacology per triennial
6 registration period. [The education shall be in the area of ocular
7 disease and pharmacology and may include both didactic and clinical
8 components.] Each optometrist certified to use oral therapeutic pharma-
9 ceutical agents shall, in addition to the minimum thirty-six hours of
10 continuing education provided for in this subdivision, complete an addi-
11 tional minimum of eighteen hours of continuing education related to
12 systemic disease and therapeutic treatment per triennial registration
13 period. Such educational programs may include both didactic and clinical
14 components and shall be approved in advance by the department [and
15 evidence of the completion of this requirement shall be submitted with
16 each application for license renewal as required by section sixty-five
17 hundred two of this chapter]. Beginning on January first, two thousand
18 twenty-three, all sponsors of continuing education courses seeking
19 advanced approval from the department shall file an application and pay
20 a fee determined by the department in accordance with the regulations of
21 the commissioner. An optometrist subject to the provisions of this
22 subdivision whose first registration date following the effective date
23 of this section occurs less than three years from such effective date,
24 but on or after January first, two thousand twenty-three, shall complete
25 continuing education hours on a prorated basis at the rate of one hour
26 per month for the period beginning January first, two thousand twenty-
27 three up to the first registration date thereafter. An optometrist who
28 has not satisfied the mandatory continuing education requirement pursu-
29 ant to this subdivision shall not be issued a triennial registration
30 certificate by the department and shall not practice unless and until a
31 conditional registration is issued as provided for in paragraph (b) of
32 this subdivision. Continuing education hours taken during one triennium
33 may not be transferred to the subsequent triennium.
34 (b) The department, in its discretion, may issue a conditional regis-
35 tration to an optometrist who fails to meet the continuing education
36 requirements established in paragraph (a) of this subdivision, but who
37 agrees to make up any deficiencies and complete any additional education
38 which the department may require. The fee for such a conditional regis-
39 tration shall be the same as, and in addition to, the fee for the trien-
40 nial registration. The duration of such conditional registration shall
41 be determined by the department, but shall not exceed one year. Any
42 optometrist who is notified of the denial of registration for failure to
43 submit evidence, satisfactory to the department, of required continuing
44 education and who practices without such registration may be subject to
45 disciplinary proceedings pursuant to section sixty-five hundred ten of
46 this title.
47 (c) In accordance with the intent of this section, adjustment to the
48 mandatory continuing education requirement may be granted by the depart-
49 ment for reasons of health that are certified by an appropriate health
50 care professional, for extended active duty with the armed forces of the
51 United States, or for other good cause acceptable to the department
52 which may prevent compliance.
53 (d) An optometrist not engaged in practice, as determined by the
54 department, shall be exempt from the mandatory continuing education
55 requirement upon the filing of a statement with the department declaring
56 such status. Any licensee who returns to the practice of optometry
S. 1519 5
1 during the triennial registration period shall notify the department
2 prior to reentering the profession and shall meet such continuing educa-
3 tion requirements as shall be prescribed by regulations of the commis-
4 sioner.
5 (e) Optometrists subject to the provisions of this subdivision shall
6 maintain adequate documentation of completion of acceptable continuing
7 education credits and shall provide such documentation at the request of
8 the department. Failure to provide such documentation upon the request
9 of the department shall be an act of misconduct subject to disciplinary
10 proceedings pursuant to section sixty-five hundred ten of this title.
11 (f) The mandatory continuing education fee shall be determined by the
12 department. Such fee shall be payable on or before the first day of
13 each triennial registration period, and shall be paid in addition to the
14 triennial registration fee required by subdivision eight of section
15 seventy-one hundred four of this article.
16 § 10. The subdivision heading and subparagraph (i) of paragraph (a) of
17 subdivision 8 of section 7101-a of the education law, as added by chap-
18 ter 517 of the laws of 1995, are amended to read as follows:
19 Notice to patient with the use or prescription of topical therapeutic
20 pharmaceutical agents and therapeutic pharmaceutical agents for treat-
21 ment of glaucoma and ocular hypertension.
22 (i) An optometrist prescribing topical steroids or antiviral medica-
23 tion shall inform each patient that in the event the condition does not
24 improve within five days, a physician of the patient's choice will be
25 notified.
26 § 11. Subdivision 10 of section 7101-a of the education law, as added
27 by chapter 517 of the laws of 1995, is amended to read as follows:
28 10. Pharmaceutical agents. Optometrists who have been approved and
29 certified by the department shall be permitted to use the following
30 drugs:
31 (a) Diagnostic pharmaceuticals.
32 (b) Those optometrists having been certified for [phase one] topical
33 therapeutic pharmaceutical agents shall be authorized [(i) to use and
34 recommend all nonprescription medications appropriate for ocular disease
35 whether intended for topical or oral use; and (ii)] to use and prescribe
36 all [phase one] topical therapeutic pharmaceutical agents specified in
37 paragraph (e) of subdivision one of this section, which are FDA approved
38 and commercially available for topical use.
39 In the event an optometrist treats a patient with topical antiviral or
40 steroidal drugs and the patient's condition either fails to improve or
41 worsens within five days, the optometrist shall notify a physician
42 designated by the patient or, if none, by the treating optometrist.
43 (c) Those optometrists having been certified for [phase two] therapeu-
44 tic pharmaceutical agents for treatment of glaucoma and ocular hyperten-
45 sion shall be authorized to use and prescribe [phase two] therapeutic
46 pharmaceutical agents for treatment of glaucoma and ocular hypertension
47 specified in paragraph (f) of subdivision one of this section, which are
48 FDA approved and commercially available.
49 (d) Those optometrists having been certified for oral therapeutic
50 pharmaceutical agents shall be authorized to use and prescribe oral
51 therapeutic pharmaceutical agents specified in paragraph (g) of subdivi-
52 sion one of this section, which are FDA approved and commercially avail-
53 able and shall comply with all safety information and side-effect and
54 warning advisories contained in the most current physicians' desk refer-
55 ence.
S. 1519 6
1 (e) Those optometrists having been certified for topical therapeutic
2 pharmaceutical agents, therapeutic pharmaceutical agents for treatment
3 of glaucoma and ocular hypertension or oral therapeutic pharmaceutical
4 agents shall be authorized to use and recommend all nonprescription
5 medications, whether intended for topical or oral use, appropriate for
6 the treatment of the eye and adnexa.
7 § 12. Subdivision 8 of section 7104 of the education law, as amended
8 by chapter 517 of the laws of 1995, is amended to read as follows:
9 (8) Fees: pay a fee of two hundred twenty dollars to the department
10 for admission to a department conducted examination and for an initial
11 license, a fee of one hundred fifteen dollars for each reexamination, a
12 fee of one hundred thirty-five dollars for an initial license for
13 persons not requiring admission to a department conducted examination,
14 [and] a fee of two hundred ten dollars for each triennial registration
15 period, [and] for additional authorization for the purpose of utilizing
16 diagnostic pharmaceutical agents, a fee of sixty dollars, and for
17 certification to use or prescribe oral therapeutic pharmaceutical
18 agents, a fee of two hundred fifty dollars.
19 § 13. This act shall take effect two years after it shall have become
20 a law; provided that section nine of this act shall take effect January
21 1, 2023. Effective immediately, the addition, amendment and/or repeal
22 of any rule or regulation necessary for the implementation of this act
23 on its effective date are authorized to be made and completed on or
24 before such effective date.