NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A1921
SPONSOR: Paulin TITLE OF BILL:
An act to amend the education law, in relation to the use of oral medi-
cations by optometrists
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 classes of oral
therapeutic pharmaceutical agents 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 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 pharmaceutical agents for the treatment of glaucoma and
ocular hypertension, have completed a forty-hour oral therapeutic phar-
maceutical agent certification course and have passed an examination
acceptable to the state education department. The course curriculum
shall include instruction in pharmacology and drug interaction in treat-
ing ocular disease and shall be taught through clinical case scenarios
and emphasize clinical decision-making. Optometrists must complete the
certification course and pass the examination within five years of the
department's approval of the initial certification course or the initial
examination, whichever is later.
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, 2021 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 eighteen 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 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 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 types of oral medications that may be
prescribed, promote greater coordination in care with a patient's physi-
cian, 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 complete the course and pass the examination within
five years of the department's approval of the initial certification
course or the initial examination, whichever is later.
PRIOR LEGISLATIVE HISTORY:
A.1193C, 2020, passed Assembly / S.4035A, 2020, amended and recommitted
to higher education.
A.1193C, 2019, amended and recommitted to higher education / S.4035A,
2019, passed Senate.
A.6751-A, 2017 and 2018, referred to higher education. Same as S.5235,
2017 referred to higher education, 2018 passed Senate.
A.9961-A, 2016 referred to higher education. Same 'as:5.7440-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 5.2667, 2009
and 2010 referred to higher education. Similar to A.8001, 2007 and 2008
referred to higher education. Same as 5.4519, 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 5.4482, 2001 and
2002 referred to higher education.
FISCAL IMPLICATION:
None to the State.
EFFECTIVE DATE:
This act shall take effect two years after it shall have become a law;
provided that section nine of this act shall take effect on January 1,
2022. Effective immediately, the addition, amendment and/or repeal of
any rule or regulation necessary for the implementation of this act on
its effective date are authorized and directed to be made and completed
on or before such effective date.
