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A01921 Memo:

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.
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