A06751 Summary:

BILL NOA06751A
 
SAME ASSAME AS S05235-A
 
SPONSORPaulin
 
COSPNSRCook, Cymbrowitz, Abinanti, Gunther, Weprin, Hevesi, Ryan, Titus, Stirpe, Skoufis, Buchwald, DiPietro, Brabenec, Blake, Fahy, Ortiz, Colton, Walter, Norris, McDonald, Barrett, Pheffer Amato, Dinowitz, Oaks, Lalor, Zebrowski, Steck, Jenne, Hunter, Bronson, Solages, Peoples-Stokes, De La Rosa, Miller B, Raia, Garbarino, Morinello, Fitzpatrick, Dickens, Magnarelli, Pichardo, Santabarbara, Giglio, Pellegrino, Rosenthal D, Kim, Rodriguez, Abbate, Jones, Arroyo, Vanel, McDonough, Hooper, Aubry, Rosenthal L, Englebright, Lavine, Murray, D'Urso, Jaffee, Joyner, Seawright, Miller ML
 
MLTSPNSRBarclay, Blankenbush, Butler, Cahill, Crouch, Cusick, Epstein, Errigo, Friend, Galef, Goodell, Gottfried, Hawley, Hikind, Lentol, Lifton, Lupardo, Magee, Palmesano, Rivera, Skartados, Stec, Tague, Thiele, Walsh, Woerner, Wright
 
Amd 7101-a & 7104, Ed L
 
Relates to the use of oral medications by optometrists.
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A06751 Actions:

BILL NOA06751A
 
03/16/2017referred to higher education
01/03/2018referred to higher education
04/18/2018amend and recommit to higher education
04/18/2018print number 6751a
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A06751 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A6751A
 
SPONSOR: Paulin (MS)
  TITLE OF BILL: An act to amend the education law, in relation to the use of oral medications by optometrists; and providing for the repeal of certain provisions upon expiration thereof   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 list of specific oral therapeutic pharmaceutical agents, including the generic equiv- alents of the listed drugs as provided, that optometrists, once certi- fied, 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 pharmaceu- tical agents for the treatment of glaucoma and ocular hypertension, have completed a forty-hour oral therapeutic pharmaceutical agent certif- ication course and have passed an examination acceptable to the state board of optometry. The course curriculum shall include instruction in pharmacology and drug interaction in treating ocular disease and shall be taught through clinical case scenarios and emphasize clinical deci- sion-making. Optometrists must pass the examination within five years of the department's approval of the initial certification course or the initial examination, whichever is later. Optometrists would be required to retake and complete the certification course if they fail to pass the examination after three attempts, and then retake the examination. Further, optometrists may be authorized to retake the examination and to become certified beyond the five year timeframe 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, 2007 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 thirty-nine hours of continuing educa- tion 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 amends the unconsolidated law to require optometrists certified to prescribe oral therapeutic pharmaceutical agents to submit a form to SED on a quarterly basis detailing the optometrist's license number and national provider identifier, 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 require- ments set forth in subdivision (2) of this section shall remain in effect from the approval by SED of the initial oral therapeutic pharma- ceutical 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 en- hancements to the curriculum provided for in this section and other educational mate- rials and to assist in ensuring patient safety. If evidence of non-com- pliance is found, the committee shall refer such information to the Commissioner of Education and the State Office of Professions for inves- tigation and, if applicable, disciplinary action. The bill affirms that the responsibilities of the committee shall not limit SED's authority to review, investigate and refer matters related to the professional conduct of a licensed provider. If one or more databases containing electronic prescriber information relating to oral therapeutic pharma- ceutical 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 fourteen 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 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 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 pass the examination within five years of the department's approval of the initial certification course or the initial examination, whichever is later, but would be permitted to retake the exam and to become certified after that timeframe upon the Commissioner of Education's determination of good cause which would include circum- stances related to an applicant's disability, illness including episodic and chronic and persistent conditions, limited English proficiency, adverse personal circumstances, or other circumstances as determined by the commissioner.   PRIOR LEGISLATIVE HISTORY: Similar to A.6751, 2017 referred to higher education. Same as S.5235, 2017 referred to higher education. A.9961-A, 2016 referred to higher education. Same as S.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 201.2 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 eighteen months after it shall have become a law; provided that (i) the unconsolidated law added by section thirteen 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.
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A06751 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         6751--A
 
                               2017-2018 Regular Sessions
 
                   IN ASSEMBLY
 
                                     March 16, 2017
                                       ___________
 
        Introduced  by  M.  of  A.  PAULIN, COOK, CYMBROWITZ, ABINANTI, GUNTHER,
          WEPRIN, HEVESI, RYAN,  TITUS,  STIRPE,  SKOUFIS,  BUCHWALD,  DiPIETRO,
          BRABENEC,  BLAKE,  FAHY,  ORTIZ,  COLTON,  WALTER,  NORRIS,  McDONALD,
          BARRETT,  PHEFFER AMATO,  DINOWITZ,  OAKS,  LALOR,  ZEBROWSKI,  STECK,
          JENNE,  HUNTER, BRONSON, SOLAGES, PEOPLES-STOKES, DE LA ROSA, B. MILL-
          ER, RAIA,  GARBARINO,  MORINELLO,  FITZPATRICK,  DICKENS,  MAGNARELLI,
          PICHARDO,  SANTABARBARA, GIGLIO, PELLEGRINO, D. ROSENTHAL, KIM, RODRI-
          GUEZ, ABBATE, JONES -- Multi-Sponsored by -- M. of A. BARCLAY,  BLANK-
          ENBUSH,   BUTLER,  CAHILL,  CROUCH,  CUSICK,  ERRIGO,  FRIEND,  GALEF,
          GOODELL, GOTTFRIED, HAWLEY, HIKIND, LENTOL, LUPARDO, MAGEE, PALMESANO,
          RIVERA, SKARTADOS, STEC, THIELE, WALSH, WOERNER, WRIGHT --  read  once
          and  referred  to  the Committee on Higher Education -- recommitted to
          the Committee on Higher Education in accordance with Assembly Rule  3,
          sec.  2  --  committee  discharged, bill amended, ordered reprinted as
          amended and recommitted to said committee
 
        AN ACT to amend the education law, in relation to the use of oral  medi-
          cations  by  optometrists;  and  providing  for  the repeal of certain
          provisions upon expiration thereof

          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;
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04288-12-7

        A. 6751--A                          2
 
     1    (v) antiviral agents;
     2    (vi) hyperosmotic/hypertonic agents;
     3    (vii) cycloplegics;
     4    (viii) artificial tears and lubricants; and
     5    (ix) immunosuppressive agents.
     6    § 2. Paragraph (f) of subdivision 1 of section 7101-a of the education
     7  law,  as added by chapter 517 of the laws of 1995, is amended to read as
     8  follows:
     9    (f) [Phase two  therapeutic]  Therapeutic  pharmaceutical  agents  for
    10  treatment  of glaucoma and ocular hypertension.  [Phase two] Therapeutic
    11  pharmaceutical agents for treatment of glaucoma and ocular  hypertension
    12  shall  mean those drugs which shall be limited to topical application to
    13  the surface of the eye and shall be limited to:
    14    (i) beta blockers;
    15    (ii) alpha agonists;
    16    (iii) direct acting cholinergic agents;
    17    (iv) prostaglandin analogs; and
    18    (v) carbonic anhydrase inhibitors.
    19    § 3. Subdivision 1 of section 7101-a of the education law  is  amended
    20  by adding a new paragraph (g) to read as follows:
    21    (g)  Oral  therapeutic pharmaceutical agents. Oral therapeutic pharma-
    22  ceutical agents shall mean those  orally  administered  drugs  used  for
    23  therapeutic purposes solely for the treatment of diseases of the eye and
    24  adnexa and shall be limited to:
    25    (i) the following antibiotics, including, where applicable, the gener-
    26  ic equivalent of any of the listed drugs:
    27    (1) augmentin;
    28    (2) keflex;
    29    (3) azithromycin;
    30    (4) bactrim;
    31    (5) doxycycline; and
    32    (6) tetracycline;
    33    (ii)   the   following   decongestants/anti-allergenic/antihistamines,
    34  including the generic equivalents of the listed drugs:
    35    (1) clarinex;
    36    (2) xyzal; and
    37    (3) singulair;
    38    (iii) the following antiglaucoma agents, including the generic  equiv-
    39  alents  of  such  agents,  used for the management of acute increases in
    40  intraocular pressure; provided,  however,  an  optometrist  may  use  or
    41  prescribe a maximum of one twenty-four hour prescription and shall imme-
    42  diately  refer  the  patient  to  a  licensed  physician specializing in
    43  diseases of the eye:
    44    (1) diamox; and
    45    (2) neptazane;
    46    (iv) the following antiviral agents, including the generic equivalents
    47  of such agents, used for herpes zoster ophthalmicus; provided an optome-
    48  trist shall  use  or  prescribe  in  maximum,  seven-day  prescriptions;
    49  provided, however, if a patient is diagnosed with herpes zoster ophthal-
    50  micus  and  has not already been examined by a primary care physician or
    51  other appropriate physician for such  viral  condition,  an  optometrist
    52  shall  refer  the patient to a licensed primary care physician, licensed
    53  physician specializing in diseases of  the  eye,  or  other  appropriate
    54  physician within three days of such diagnosis:
    55    (1) valacyclovir; and
    56    (2) acyclovir; and

        A. 6751--A                          3
 
     1    (v) the following non-steroidal anti-inflammatory agents:
     2    (1) cox-2 inhibitors;
     3    (2) ibuprofen; and
     4    (3) naproxen.
     5    §  4.  The  subdivision  heading and paragraph (a) of subdivision 4 of
     6  section 7101-a of the education law, as added by chapter 517 of the laws
     7  of 1995, are amended to read as follows:
     8    [Phase one] Topical  therapeutic  pharmaceutical  agents.  (a)  Before
     9  using  or  prescribing  [phase  one]  topical therapeutic pharmaceutical
    10  agents, each optometrist shall have completed  at  least  three  hundred
    11  hours of clinical training in the diagnosis, treatment and management of
    12  patients  with  ocular  disease other than glaucoma and ocular hyperten-
    13  sion, not fewer than twenty-five hours of such training shall have  been
    14  completed  subsequent  to  June thirtieth, nineteen hundred ninety-three
    15  and additionally shall either have taken  and  successfully  passed  the
    16  treatment  and  management  of  ocular  diseases portion of the National
    17  Board of Examiners in Optometry test  or  have  taken  and  successfully
    18  passed an examination acceptable to the board.
    19    § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education
    20  law,  as added by chapter 517 of the laws of 1995, is amended to read as
    21  follows:
    22    (b) Before using or prescribing [phase two] therapeutic pharmaceutical
    23  agents for treatment of glaucoma and ocular hypertension, an optometrist
    24  must be certified for diagnostic and  [phase  one]  topical  therapeutic
    25  agents  and  have  completed an additional one hundred hours of clinical
    26  training in the diagnosis, treatment and  management  of  patients  with
    27  glaucoma  and  ocular  hypertension, not fewer than twenty-five hours of
    28  such training shall have been completed subsequent to July first,  nine-
    29  teen  hundred  ninety-four, and shall have taken and successfully passed
    30  an oral or written examination acceptable by the board.
    31    § 6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of  the
    32  education  law are relettered paragraphs (d) and (e) and a new paragraph
    33  (c) is added to read as follows:
    34    (c)  Before  using  or  prescribing  oral  therapeutic  pharmaceutical
    35  agents, an optometrist must be certified to prescribe diagnostic pharma-
    36  ceutical  agents  and topical therapeutic and therapeutic pharmaceutical
    37  agents for treatment of glaucoma and ocular hypertension, have completed
    38  an oral therapeutic pharmaceutical agent certification course  and  have
    39  passed  an examination within five years of the department's approval of
    40  the initial certification course or the initial  examination,  whichever
    41  is later.
    42    (i)  The  curriculum  for the course shall include, but not be limited
    43  to, instruction in pharmacology and drug interaction in treating  ocular
    44  disease  and  be  taught  through  clinical case scenarios and emphasize
    45  clinical decision making and shall be no less than forty hours, of which
    46  no less than twenty-four hours shall be live instruction.
    47    (ii) Such course shall qualify towards meeting the  continuing  educa-
    48  tion  per  triennial  registration  requirement  pursuant to subdivision
    49  seven of this section.
    50    (iii) The examination shall test the knowledge  of  materials  in  the
    51  curriculum  and  reflect  the provisions of paragraph (g) of subdivision
    52  one of this section, and shall be acceptable to the  department.  If  an
    53  optometrist  fails  to pass the examination, such optometrist may retake
    54  the examination; provided, however, that if an optometrist fails to pass
    55  the examination  after  three  attempts,  such  optometrist  must  again
    56  complete the certification course in order to retake the examination. An

        A. 6751--A                          4

     1  optometrist shall be required to complete the certification course after
     2  each subsequent failure to pass the examination three times. If an opto-
     3  metrist  requires more time to pass the examination and to become certi-
     4  fied  than  the  five-year  period  provided for in this paragraph, such
     5  optometrist may be authorized to retake the examination  and  to  become
     6  certified  beyond  such period upon application by the optometrist and a
     7  showing of good cause as may be acceptable to the commissioner.
     8    (iv) The initial, and any subsequent, curriculum and examination shall
     9  be subject to review and approval by the department.
    10    (v) The requirement for  the  oral  therapeutic  pharmaceutical  agent
    11  certification  course  and  examination shall not apply to those optome-
    12  trists who graduated from an accredited college of optometry  subsequent
    13  to  January  first,  two  thousand seven and have taken and successfully
    14  passed the National Board of Examiners in Optometry test or an  examina-
    15  tion acceptable to the department.
    16    § 7. Subdivision 5 of section 7101-a of the education law, as added by
    17  chapter 517 of the laws of 1995, is amended to read as follows:
    18    5.  Suspension  of  certification.  The  department  shall suspend the
    19  certification for the use and prescribing of [phase one] topical  thera-
    20  peutic  agents of any optometrist who fails to receive certification for
    21  [phase two] therapeutic pharmaceutical agents for treatment of  glaucoma
    22  and  ocular hypertension within three years of having been certified for
    23  [phase one] topical therapeutic pharmaceutical agents.
    24    § 8. The subdivision heading of subdivision 6 of section 7101-a of the
    25  education law, as added by chapter 517 of the laws of 1995,  is  amended
    26  to read as follows:
    27    Consultation  with  use  of certain topical therapeutic pharmaceutical
    28  agents for treatment of glaucoma and ocular hypertension.
    29    § 9. Subdivision 7 of section 7101-a of the education law, as added by
    30  chapter 517 of the laws of 1995, is amended to read as follows:
    31    7. Continuing education. Each optometrist certified to use [phase  one
    32  or  phase two] topical therapeutic pharmaceutical agents and therapeutic
    33  pharmaceutical agents for treatment of glaucoma and ocular hypertension,
    34  shall complete a minimum of thirty-six hours of continuing education  in
    35  the  area  of ocular disease and pharmacology per triennial registration
    36  period. [The education shall be in the area of ocular disease and  phar-
    37  macology  and  may  include both didactic and clinical components.] Each
    38  optometrist certified to  use  oral  therapeutic  pharmaceutical  agents
    39  shall,  in addition to the minimum thirty-six hours of continuing educa-
    40  tion provided for in this subdivision, complete an additional minimum of
    41  thirty-nine hours of continuing education related  to  systemic  disease
    42  and therapeutic treatment per triennial registration period. Such educa-
    43  tional  programs  may  include both didactic and clinical components and
    44  shall be approved in advance by  the  department  and  evidence  of  the
    45  completion  of this requirement shall be submitted with each application
    46  for license renewal as required by section  sixty-five  hundred  two  of
    47  this chapter.
    48    § 10. The subdivision heading and subparagraph (i) of paragraph (a) of
    49  subdivision  8 of section 7101-a of the education law, as added by chap-
    50  ter 517 of the laws of 1995, are amended to read as follows:
    51    Notice to patient with the use or prescription of topical  therapeutic
    52  pharmaceutical  agents  and therapeutic pharmaceutical agents for treat-
    53  ment of glaucoma and ocular hypertension.
    54    (i) An optometrist prescribing topical steroids or  antiviral  medica-
    55  tion  shall inform each patient that in the event the condition does not

        A. 6751--A                          5
 
     1  improve within five days, a physician of the patient's  choice  will  be
     2  notified.
     3    §  11. Subdivision 10 of section 7101-a of the education law, as added
     4  by chapter 517 of the laws of 1995, is amended to read as follows:
     5    10. Pharmaceutical agents. Optometrists who  have  been  approved  and
     6  certified  by  the  department  shall  be permitted to use the following
     7  drugs:
     8    (a) Diagnostic pharmaceuticals.
     9    (b) Those optometrists having been certified for [phase  one]  topical
    10  therapeutic  pharmaceutical  agents  shall be authorized [(i) to use and
    11  recommend all nonprescription medications appropriate for ocular disease
    12  whether intended for topical or oral use; and (ii)] to use and prescribe
    13  all [phase one] topical therapeutic pharmaceutical agents  specified  in
    14  paragraph (e) of subdivision one of this section, which are FDA approved
    15  and commercially available for topical use.
    16    In the event an optometrist treats a patient with topical antiviral or
    17  steroidal  drugs  and the patient's condition either fails to improve or
    18  worsens within five days,  the  optometrist  shall  notify  a  physician
    19  designated by the patient or, if none, by the treating optometrist.
    20    (c) Those optometrists having been certified for [phase two] therapeu-
    21  tic pharmaceutical agents for treatment of glaucoma and ocular hyperten-
    22  sion  shall  be  authorized to use and prescribe [phase two] therapeutic
    23  pharmaceutical agents for treatment of glaucoma and ocular  hypertension
    24  specified in paragraph (f) of subdivision one of this section, which are
    25  FDA approved and commercially available.
    26    (d)  Those  optometrists  having  been  certified for oral therapeutic
    27  pharmaceutical agents shall be authorized  to  use  and  prescribe  oral
    28  therapeutic pharmaceutical agents specified in paragraph (g) of subdivi-
    29  sion one of this section, which are FDA approved and commercially avail-
    30  able  and  shall  comply with all safety information and side-effect and
    31  warning advisories contained in the most current physicians' desk refer-
    32  ence.
    33    (e) Those optometrists having been certified for  topical  therapeutic
    34  pharmaceutical  agents,  therapeutic pharmaceutical agents for treatment
    35  of glaucoma and ocular hypertension or oral  therapeutic  pharmaceutical
    36  agents  shall  be  authorized  to  use and recommend all nonprescription
    37  medications, whether intended for topical or oral use,  appropriate  for
    38  the treatment of the eye and adnexa.
    39    §  12.  Subdivision 8 of section 7104 of the education law, as amended
    40  by chapter 517 of the laws of 1995, is amended to read as follows:
    41    (8) Fees: pay a fee of two hundred twenty dollars  to  the  department
    42  for  admission  to a department conducted examination and for an initial
    43  license, a fee of one hundred fifteen dollars for each reexamination,  a
    44  fee  of  one  hundred  thirty-five  dollars  for  an initial license for
    45  persons not requiring admission to a department  conducted  examination,
    46  [and]  a  fee of two hundred ten dollars for each triennial registration
    47  period, [and] for additional authorization for the purpose of  utilizing
    48  diagnostic  pharmaceutical  agents,  a  fee  of  sixty  dollars, and for
    49  certification  to  use  or  prescribe  oral  therapeutic  pharmaceutical
    50  agents, a fee of two hundred fifty dollars.
    51    §  13. Oral therapeutic pharmaceutical agent implementation review. 1.
    52  For purposes of this section, the term  "commissioner"  shall  mean  the
    53  commissioner  of  the  state education department; and the term "depart-
    54  ment" shall mean the state education department.
    55    2.  Each optometrist certified to use oral therapeutic  pharmaceutical
    56  agents  pursuant  to paragraph (c) of subdivision four of section 7101-a

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     1  of the education law shall provide the department with information, on a
     2  form prescribed by the commissioner, related to the prescription or  use
     3  of oral therapeutic pharmaceutical agents provided for in section 7101-a
     4  of  the  education law. Such information shall include the optometrist's
     5  license number and the national provider identifier  as  established  by
     6  the  centers  for  medicare  and  medicaid  services,  whether  no  oral
     7  prescriptions have been issued and in the event that oral  prescriptions
     8  have been issued, then the following information shall be required:  the
     9  prescribed  or used oral therapeutic pharmaceutical agent, the dosage of
    10  such agent, the date of the prescription, the diagnosis of  the  patient
    11  for  which  the agent was prescribed or used, and whether a referral was
    12  made in accordance with paragraph (g) of subdivision  one  of    section
    13  7101-a  of  the  education law.   Such information shall not include any
    14  patient identifying information and must otherwise be in compliance with
    15  all state and federal requirements related to protected health  informa-
    16  tion.  Each  form  shall be submitted by mail or electronic means to the
    17  department on a quarterly basis.  If a database of all oral  therapeutic
    18  pharmaceutical agents prescribed or used by optometrists is, or becomes,
    19  available  to  the committee provided for in this act, then optometrists
    20  shall be advised by the commissioner that quarterly reporting forms will
    21  no longer be required.  The requirements of this section shall remain in
    22  effect for five years  following  approval  by  the  department  of  the
    23  initial  oral  therapeutic pharmaceutical agent certification course and
    24  examination pursuant to paragraph (c) of  subdivision  four  of  section
    25  7101-a  of  the education law, after which time these requirements shall
    26  expire and no longer have effect.
    27    3. The commissioner shall appoint a committee to advise and assist the
    28  commissioner in evaluating compliance with  the  provisions  of  section
    29  7101-a  of  the education law and to identify any necessary enhancements
    30  to the curriculum provided for in such  section  and  other  educational
    31  materials  and to assist in ensuring patient safety. The committee shall
    32  consist of one pharmacist, one optometrist upon the recommendation of  a
    33  statewide  professional  organization  consisting  of  optometrists, one
    34  ophthalmologist upon the  recommendation  of  a  statewide  professional
    35  organization consisting of ophthalmologists, and one expert in the field
    36  of public health who shall be designated as chair by the commissioner in
    37  consultation  with  the commissioner of the department of health and who
    38  shall be neither an ophthalmologist nor an optometrist.
    39    4. The commissioner shall submit each form received pursuant  to  this
    40  section  to the committee, except as otherwise provided in this subdivi-
    41  sion.  The committee shall review the forms and  shall  randomly  cross-
    42  check  such  submissions  with  a  publicly  available or other database
    43  containing electronic prescriber information. Should a database  of  all
    44  oral  therapeutic  pharmaceutical  agents  prescribed or used by optome-
    45  trists pursuant to section 7101-a of the education law become available,
    46  and the commissioner determines and advises optometrists that  quarterly
    47  reports  are  no  longer  necessary, then the committee shall review the
    48  database and ascertain the prescribing information for all  optometrists
    49  consistent  with  section  7101-a  of the education law.   The committee
    50  shall advise the commissioner as to compliance with  the  provisions  of
    51  section  7101-a  of  the  education  law  for  the purpose of evaluating
    52  compliance with the provisions of section 7101-a of  the  education  law
    53  including the applicable referrals and dosing limitations and to identi-
    54  fy  any  necessary  enhancements to the curriculum provided for in para-
    55  graph (c) of subdivision 4 of section 7101-a of the  education  law  and
    56  other  educational  materials  and to assist in ensuring patient safety.

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     1  Upon finding evidence of non-compliance by any optometrist, the  commit-
     2  tee  shall  refer such information to the commissioner and to the office
     3  of professions within the department for investigation and, if  applica-
     4  ble,  disciplinary  action.  Nothing  in this subdivision is intended to
     5  modify or otherwise limit the department's authority  or  discretion  to
     6  review,  investigate  and  refer  matters  related  to  the professional
     7  conduct of a licensed provider.
     8    § 14. This act shall take effect eighteen months after it  shall  have
     9  become a law; provided that:
    10    (a)  section  thirteen of this act shall expire and be deemed repealed
    11  five years following the approval by the department of education of  the
    12  initial  certification  course  or the initial examination, whichever is
    13  later, pursuant to paragraph (c) of subdivision 4 of section  7101-a  of
    14  the education law as added by section six of this act;
    15    (b)  the  commissioner  of education shall notify the legislative bill
    16  drafting commission upon approval of the  initial  certification  course
    17  and  examination  required  in section six of this act in order that the
    18  commission may maintain an accurate and timely effective  data  base  of
    19  the official text of the laws of the state of New York in furtherance of
    20  effectuating  the  provisions  of  section 44 of the legislative law and
    21  section 70-b of the public officers law; and
    22    (c) any rule or regulation necessary for the timely implementation  of
    23  this  act  on  its effective date shall be promulgated on or before such
    24  effective date.
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