S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1193
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 14, 2019
                                ___________
 
 Introduced  by  M.  of  A.  PAULIN, COOK, CYMBROWITZ, ABINANTI, GUNTHER,
   WEPRIN, HEVESI, RYAN, TITUS,  STIRPE,  BUCHWALD,  DiPIETRO,  BRABENEC,
   BLAKE,  FAHY, ORTIZ, COLTON, NORRIS, BARRETT, PHEFFER AMATO, DINOWITZ,
   LALOR, ZEBROWSKI, STECK,  HUNTER,  BRONSON,  SOLAGES,  PEOPLES-STOKES,
   DE LA ROSA,  B. MILLER, RAIA, GARBARINO, MORINELLO, FITZPATRICK, DICK-
   ENS, MAGNARELLI, PICHARDO, SANTABARBARA,  GIGLIO,  D. ROSENTHAL,  KIM,
   RODRIGUEZ,  ABBATE,  JONES, ARROYO, VANEL, McDONOUGH, AUBRY, L. ROSEN-
   THAL,  ENGLEBRIGHT,  LAVINE,  D'URSO,   JAFFEE,   JOYNER,   SEAWRIGHT,
   M. L. MILLER  --  Multi-Sponsored by -- M. of A. BARCLAY, BLANKENBUSH,
   CAHILL, CROUCH, CUSICK, EPSTEIN, FRIEND,  GALEF,  GOODELL,  GOTTFRIED,
   HAWLEY,  LENTOL,  LIFTON,  LUPARDO,  PALMESANO,  RIVERA,  STEC, TAGUE,
   THIELE, WALSH, WOERNER, WRIGHT  --  read  once  and  referred  to  the
   Committee on Higher Education
 
 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:

   Section 1. Paragraph (e) of subdivision 1 of  section  7101-a  of  the
 education  law,  as added by chapter 517 of the laws of 1995, is amended
 to read as follows:
   (e) [Phase one] TOPICAL therapeutic pharmaceutical agents. [Phase one]
 TOPICAL THERAPEUTIC pharmaceutical agents shall mean those  drugs  which
 shall  be  limited  to topical application to the surface of the eye for
 therapeutic purposes and shall be limited to:
   (i) antibiotic/antimicrobials;
   (ii) decongestants/anti-allergenics;
   (iii) non-steroidal anti-inflammatory agents;
   (iv) steroidal anti-inflammatory agents;
   (v) antiviral agents;
   (vi) hyperosmotic/hypertonic agents;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD01275-01-9

 A. 1193                             2
 
   (vii) cycloplegics;
   (viii) artificial tears and lubricants; AND
   (IX) IMMUNOSUPPRESSIVE AGENTS.
   § 2. Paragraph (f) of subdivision 1 of section 7101-a of the education
 law,  as added by chapter 517 of the laws of 1995, is amended to read as
 follows:
   (f) [Phase two  therapeutic]  THERAPEUTIC  pharmaceutical  agents  FOR
 TREATMENT  OF GLAUCOMA AND OCULAR HYPERTENSION.  [Phase two] THERAPEUTIC
 pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR  HYPERTENSION
 shall  mean those drugs which shall be limited to topical application to
 the surface of the eye and shall be limited to:
   (i) beta blockers;
   (ii) alpha agonists;
   (iii) direct acting cholinergic agents;
   (IV) PROSTAGLANDIN ANALOGS; AND
   (V) CARBONIC ANHYDRASE INHIBITORS.
   § 3. Subdivision 1 of section 7101-a of the education law  is  amended
 by adding a new paragraph (g) to read as follows:
   (G)  ORAL  THERAPEUTIC PHARMACEUTICAL AGENTS. ORAL THERAPEUTIC PHARMA-
 CEUTICAL AGENTS SHALL MEAN THOSE  ORALLY  ADMINISTERED  DRUGS  USED  FOR
 THERAPEUTIC PURPOSES SOLELY FOR THE TREATMENT OF DISEASES OF THE EYE AND
 ADNEXA AND SHALL BE LIMITED TO:
   (I) THE FOLLOWING ANTIBIOTICS, INCLUDING, WHERE APPLICABLE, THE GENER-
 IC EQUIVALENT OF ANY OF THE LISTED DRUGS:
   (1) AUGMENTIN;
   (2) KEFLEX;
   (3) AZITHROMYCIN;
   (4) BACTRIM;
   (5) DOXYCYCLINE; AND
   (6) TETRACYCLINE;
   (II)   THE   FOLLOWING   DECONGESTANTS/ANTI-ALLERGENIC/ANTIHISTAMINES,
 INCLUDING THE GENERIC EQUIVALENTS OF THE LISTED DRUGS:
   (1) CLARINEX;
   (2) XYZAL; AND
   (3) SINGULAIR;
   (III) THE FOLLOWING ANTIGLAUCOMA AGENTS, INCLUDING THE GENERIC  EQUIV-
 ALENTS  OF  SUCH  AGENTS,  USED FOR THE MANAGEMENT OF ACUTE INCREASES IN
 INTRAOCULAR PRESSURE; PROVIDED,  HOWEVER,  AN  OPTOMETRIST  MAY  USE  OR
 PRESCRIBE A MAXIMUM OF ONE TWENTY-FOUR HOUR PRESCRIPTION AND SHALL IMME-
 DIATELY  REFER  THE  PATIENT  TO  A  LICENSED  PHYSICIAN SPECIALIZING IN
 DISEASES OF THE EYE:
   (1) DIAMOX; AND
   (2) NEPTAZANE;
   (IV) THE FOLLOWING ANTIVIRAL AGENTS, INCLUDING THE GENERIC EQUIVALENTS
 OF SUCH AGENTS, USED FOR HERPES ZOSTER OPHTHALMICUS; PROVIDED AN OPTOME-
 TRIST SHALL  USE  OR  PRESCRIBE  IN  MAXIMUM,  SEVEN-DAY  PRESCRIPTIONS;
 PROVIDED, HOWEVER, IF A PATIENT IS DIAGNOSED WITH HERPES ZOSTER OPHTHAL-
 MICUS  AND  HAS NOT ALREADY BEEN EXAMINED BY A PRIMARY CARE PHYSICIAN OR
 OTHER APPROPRIATE PHYSICIAN FOR SUCH  VIRAL  CONDITION,  AN  OPTOMETRIST
 SHALL  REFER  THE PATIENT TO A LICENSED PRIMARY CARE PHYSICIAN, LICENSED
 PHYSICIAN SPECIALIZING IN DISEASES OF  THE  EYE,  OR  OTHER  APPROPRIATE
 PHYSICIAN WITHIN THREE DAYS OF SUCH DIAGNOSIS:
   (1) VALACYCLOVIR; AND
   (2) ACYCLOVIR; AND
   (V) THE FOLLOWING NON-STEROIDAL ANTI-INFLAMMATORY AGENTS:
   (1) COX-2 INHIBITORS;

 A. 1193                             3
 
   (2) IBUPROFEN; AND
   (3) NAPROXEN.
   §  4.  The  subdivision  heading and paragraph (a) of subdivision 4 of
 section 7101-a of the education law, as added by chapter 517 of the laws
 of 1995, are amended to read as follows:
   [Phase one] TOPICAL  therapeutic  pharmaceutical  agents.  (a)  Before
 using  or  prescribing  [phase  one]  TOPICAL therapeutic pharmaceutical
 agents, each optometrist shall have completed  at  least  three  hundred
 hours of clinical training in the diagnosis, treatment and management of
 patients  with  ocular  disease other than glaucoma and ocular hyperten-
 sion, not fewer than twenty-five hours of such training shall have  been
 completed  subsequent  to  June thirtieth, nineteen hundred ninety-three
 and additionally shall either have taken  and  successfully  passed  the
 treatment  and  management  of  ocular  diseases portion of the National
 Board of Examiners in Optometry test  or  have  taken  and  successfully
 passed an examination acceptable to the board.
   § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education
 law,  as added by chapter 517 of the laws of 1995, is amended to read as
 follows:
   (b) Before using or prescribing [phase two] therapeutic pharmaceutical
 agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION, an optometrist
 must be certified for diagnostic and  [phase  one]  TOPICAL  therapeutic
 agents  and  have  completed an additional one hundred hours of clinical
 training in the diagnosis, treatment and  management  of  patients  with
 glaucoma  and  ocular  hypertension, not fewer than twenty-five hours of
 such training shall have been completed subsequent to July first,  nine-
 teen  hundred  ninety-four, and shall have taken and successfully passed
 an oral or written examination acceptable by the board.
   § 6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of  the
 education  law are relettered paragraphs (d) and (e) and a new paragraph
 (c) is added to read as follows:
   (C)  BEFORE  USING  OR  PRESCRIBING  ORAL  THERAPEUTIC  PHARMACEUTICAL
 AGENTS, AN OPTOMETRIST MUST BE CERTIFIED TO PRESCRIBE DIAGNOSTIC PHARMA-
 CEUTICAL  AGENTS  AND TOPICAL THERAPEUTIC AND THERAPEUTIC PHARMACEUTICAL
 AGENTS FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION, HAVE COMPLETED
 AN ORAL THERAPEUTIC PHARMACEUTICAL AGENT CERTIFICATION COURSE  AND  HAVE
 PASSED  AN EXAMINATION WITHIN FIVE YEARS OF THE DEPARTMENT'S APPROVAL OF
 THE INITIAL CERTIFICATION COURSE OR THE INITIAL  EXAMINATION,  WHICHEVER
 IS LATER.
   (I)  THE  CURRICULUM  FOR THE COURSE SHALL INCLUDE, BUT NOT BE LIMITED
 TO, INSTRUCTION IN PHARMACOLOGY AND DRUG INTERACTION IN TREATING  OCULAR
 DISEASE  AND  BE  TAUGHT  THROUGH  CLINICAL CASE SCENARIOS AND EMPHASIZE
 CLINICAL DECISION MAKING AND SHALL BE NO LESS THAN FORTY HOURS, OF WHICH
 NO LESS THAN TWENTY-FOUR HOURS SHALL BE LIVE INSTRUCTION.
   (II) SUCH COURSE SHALL QUALIFY TOWARDS MEETING THE  CONTINUING  EDUCA-
 TION  PER  TRIENNIAL  REGISTRATION  REQUIREMENT  PURSUANT TO SUBDIVISION
 SEVEN OF THIS SECTION.
   (III) THE EXAMINATION SHALL TEST THE KNOWLEDGE  OF  MATERIALS  IN  THE
 CURRICULUM  AND  REFLECT  THE PROVISIONS OF PARAGRAPH (G) OF SUBDIVISION
 ONE OF THIS SECTION, AND SHALL BE ACCEPTABLE TO THE  DEPARTMENT.  IF  AN
 OPTOMETRIST  FAILS  TO PASS THE EXAMINATION, SUCH OPTOMETRIST MAY RETAKE
 THE EXAMINATION; PROVIDED, HOWEVER, THAT IF AN OPTOMETRIST FAILS TO PASS
 THE EXAMINATION  AFTER  THREE  ATTEMPTS,  SUCH  OPTOMETRIST  MUST  AGAIN
 COMPLETE THE CERTIFICATION COURSE IN ORDER TO RETAKE THE EXAMINATION. AN
 OPTOMETRIST SHALL BE REQUIRED TO COMPLETE THE CERTIFICATION COURSE AFTER
 EACH SUBSEQUENT FAILURE TO PASS THE EXAMINATION THREE TIMES. IF AN OPTO-

 A. 1193                             4
 
 METRIST  REQUIRES MORE TIME TO PASS THE EXAMINATION AND TO BECOME CERTI-
 FIED THAN THE FIVE-YEAR PERIOD PROVIDED  FOR  IN  THIS  PARAGRAPH,  SUCH
 OPTOMETRIST  MAY  BE  AUTHORIZED TO RETAKE THE EXAMINATION AND TO BECOME
 CERTIFIED  BEYOND  SUCH PERIOD UPON APPLICATION BY THE OPTOMETRIST AND A
 SHOWING OF GOOD CAUSE AS MAY BE ACCEPTABLE TO THE COMMISSIONER.
   (IV) THE INITIAL, AND ANY SUBSEQUENT, CURRICULUM AND EXAMINATION SHALL
 BE SUBJECT TO REVIEW AND APPROVAL BY THE DEPARTMENT.
   (V) THE REQUIREMENT FOR  THE  ORAL  THERAPEUTIC  PHARMACEUTICAL  AGENT
 CERTIFICATION  COURSE  AND  EXAMINATION SHALL NOT APPLY TO THOSE OPTOME-
 TRISTS WHO GRADUATED FROM AN ACCREDITED COLLEGE OF OPTOMETRY  SUBSEQUENT
 TO  JANUARY  FIRST,  TWO  THOUSAND SEVEN AND HAVE TAKEN AND SUCCESSFULLY
 PASSED THE NATIONAL BOARD OF EXAMINERS IN OPTOMETRY TEST OR AN  EXAMINA-
 TION ACCEPTABLE TO THE DEPARTMENT.
   § 7. Subdivision 5 of section 7101-a of the education law, as added by
 chapter 517 of the laws of 1995, is amended to read as follows:
   5.  Suspension  of  certification.  The  department  shall suspend the
 certification for the use and prescribing of [phase one] TOPICAL  thera-
 peutic  agents of any optometrist who fails to receive certification for
 [phase two] therapeutic pharmaceutical agents FOR TREATMENT OF  GLAUCOMA
 AND  OCULAR HYPERTENSION within three years of having been certified for
 [phase one] TOPICAL therapeutic pharmaceutical agents.
   § 8. The subdivision heading of subdivision 6 of section 7101-a of the
 education law, as added by chapter 517 of the laws of 1995,  is  amended
 to read as follows:
   Consultation  WITH  USE  OF CERTAIN TOPICAL THERAPEUTIC PHARMACEUTICAL
 AGENTS FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION.
   § 9. Subdivision 7 of section 7101-a of the education law, as added by
 chapter 517 of the laws of 1995, is amended to read as follows:
   7. Continuing education. Each optometrist certified to use [phase  one
 or  phase two] TOPICAL THERAPEUTIC PHARMACEUTICAL AGENTS AND therapeutic
 pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION,
 shall complete a minimum of thirty-six hours of continuing education  IN
 THE  AREA  OF OCULAR DISEASE AND PHARMACOLOGY per triennial registration
 period. [The education shall be in the area of ocular disease and  phar-
 macology  and  may  include both didactic and clinical components.] EACH
 OPTOMETRIST CERTIFIED TO  USE  ORAL  THERAPEUTIC  PHARMACEUTICAL  AGENTS
 SHALL,  IN ADDITION TO THE MINIMUM THIRTY-SIX HOURS OF CONTINUING EDUCA-
 TION PROVIDED FOR IN THIS SUBDIVISION, COMPLETE AN ADDITIONAL MINIMUM OF
 THIRTY-NINE HOURS OF CONTINUING EDUCATION RELATED  TO  SYSTEMIC  DISEASE
 AND THERAPEUTIC TREATMENT PER TRIENNIAL REGISTRATION PERIOD. Such educa-
 tional  programs  MAY  INCLUDE BOTH DIDACTIC AND CLINICAL COMPONENTS AND
 shall be approved in advance by  the  department  and  evidence  of  the
 completion  of this requirement shall be submitted with each application
 for license renewal as required by section  sixty-five  hundred  two  of
 this chapter.
   § 10. The subdivision heading and subparagraph (i) of paragraph (a) of
 subdivision  8 of section 7101-a of the education law, as added by chap-
 ter 517 of the laws of 1995, are amended to read as follows:
   Notice to patient WITH THE USE OR PRESCRIPTION OF TOPICAL  THERAPEUTIC
 PHARMACEUTICAL  AGENTS  AND THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREAT-
 MENT OF GLAUCOMA AND OCULAR HYPERTENSION.
   (i) An optometrist prescribing TOPICAL steroids or  antiviral  medica-
 tion  shall inform each patient that in the event the condition does not
 improve within five days, a physician of the patient's  choice  will  be
 notified.

 A. 1193                             5
 
   §  11. Subdivision 10 of section 7101-a of the education law, as added
 by chapter 517 of the laws of 1995, is amended to read as follows:
   10.  Pharmaceutical  agents.  Optometrists  who have been approved and
 certified by the department shall be  permitted  to  use  the  following
 drugs:
   (a) Diagnostic pharmaceuticals.
   (b)  Those  optometrists having been certified for [phase one] TOPICAL
 therapeutic pharmaceutical agents shall be authorized [(i)  to  use  and
 recommend all nonprescription medications appropriate for ocular disease
 whether intended for topical or oral use; and (ii)] to use and prescribe
 all  [phase  one] TOPICAL therapeutic pharmaceutical agents SPECIFIED IN
 PARAGRAPH (E) OF SUBDIVISION ONE OF THIS SECTION, which are FDA approved
 and commercially available FOR TOPICAL USE.
   In the event an optometrist treats a patient with topical antiviral or
 steroidal drugs and the patient's condition either fails to  improve  or
 worsens  within  five  days,  the  optometrist  shall notify a physician
 designated by the patient or, if none, by the treating optometrist.
   (c) Those optometrists having been certified for [phase two] therapeu-
 tic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTEN-
 SION shall be authorized to use and prescribe  [phase  two]  therapeutic
 pharmaceutical  agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION
 SPECIFIED IN PARAGRAPH (F) OF SUBDIVISION ONE OF THIS SECTION, which are
 FDA approved and commercially available.
   (D) THOSE OPTOMETRISTS HAVING  BEEN  CERTIFIED  FOR  ORAL  THERAPEUTIC
 PHARMACEUTICAL  AGENTS  SHALL  BE  AUTHORIZED  TO USE AND PRESCRIBE ORAL
 THERAPEUTIC PHARMACEUTICAL AGENTS SPECIFIED IN PARAGRAPH (G) OF SUBDIVI-
 SION ONE OF THIS SECTION, WHICH ARE FDA APPROVED AND COMMERCIALLY AVAIL-
 ABLE AND SHALL COMPLY WITH ALL SAFETY INFORMATION  AND  SIDE-EFFECT  AND
 WARNING ADVISORIES CONTAINED IN THE MOST CURRENT PHYSICIANS' DESK REFER-
 ENCE.
   (E)  THOSE  OPTOMETRISTS HAVING BEEN CERTIFIED FOR TOPICAL THERAPEUTIC
 PHARMACEUTICAL AGENTS, THERAPEUTIC PHARMACEUTICAL AGENTS  FOR  TREATMENT
 OF  GLAUCOMA  AND OCULAR HYPERTENSION OR 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.
   § 12. Subdivision 8 of section 7104 of the education law,  as  amended
 by chapter 517 of the laws of 1995, is amended to read as follows:
   (8)  Fees:  pay  a fee of two hundred twenty dollars to the department
 for admission to a department conducted examination and for  an  initial
 license,  a fee of one hundred fifteen dollars for each reexamination, a
 fee of one hundred  thirty-five  dollars  for  an  initial  license  for
 persons  not  requiring admission to a department conducted examination,
 [and] a fee of two hundred ten dollars for each  triennial  registration
 period,  [and] for additional authorization for the purpose of utilizing
 diagnostic pharmaceutical agents,  a  fee  of  sixty  dollars,  AND  FOR
 CERTIFICATION  TO  USE  OR  PRESCRIBE  ORAL  THERAPEUTIC  PHARMACEUTICAL
 AGENTS, A FEE OF TWO HUNDRED FIFTY DOLLARS.
   § 13. Oral therapeutic pharmaceutical agent implementation review.  1.
 For  purposes  of  this  section, the term "commissioner" shall mean the
 commissioner of the state education department; and  the  term  "depart-
 ment" shall mean the state education department.
   2.   Each optometrist certified to use oral therapeutic pharmaceutical
 agents pursuant to paragraph (c) of subdivision four of  section  7101-a
 of the education law shall provide the department with information, on a
 form  prescribed by the commissioner, related to the prescription or use

 A. 1193                             6
 
 of oral therapeutic pharmaceutical agents provided for in section 7101-a
 of the education law. Such information shall include  the  optometrist's
 license  number  and  the national provider identifier as established by
 the  centers  for  medicare  and  medicaid  services,  whether  no  oral
 prescriptions have been issued and in the event that oral  prescriptions
 have been issued, then the following information shall be required:  the
 prescribed  or used oral therapeutic pharmaceutical agent, the dosage of
 such agent, the date of the prescription, the diagnosis of  the  patient
 for  which  the agent was prescribed or used, and whether a referral was
 made in accordance with paragraph (g) of subdivision  one  of    section
 7101-a  of  the  education law.   Such information shall not include any
 patient identifying information and must otherwise be in compliance with
 all state and federal requirements related to protected health  informa-
 tion.  Each  form  shall be submitted by mail or electronic means to the
 department on a quarterly basis.  If a database of all oral  therapeutic
 pharmaceutical agents prescribed or used by optometrists is, or becomes,
 available  to  the committee provided for in this act, then optometrists
 shall be advised by the commissioner that quarterly reporting forms will
 no longer be required.  The requirements of this section shall remain in
 effect for five years  following  approval  by  the  department  of  the
 initial  oral  therapeutic pharmaceutical agent certification course and
 examination pursuant to paragraph (c) of  subdivision  four  of  section
 7101-a  of  the education law, after which time these requirements shall
 expire and no longer have effect.
   3. The commissioner shall appoint a committee to advise and assist the
 commissioner in evaluating compliance with  the  provisions  of  section
 7101-a  of  the education law and to identify any necessary enhancements
 to the curriculum provided for in such  section  and  other  educational
 materials  and to assist in ensuring patient safety. The committee shall
 consist of one pharmacist, one optometrist upon the recommendation of  a
 statewide  professional  organization  consisting  of  optometrists, one
 ophthalmologist upon the  recommendation  of  a  statewide  professional
 organization consisting of ophthalmologists, and one expert in the field
 of public health who shall be designated as chair by the commissioner in
 consultation  with  the commissioner of the department of health and who
 shall be neither an ophthalmologist nor an optometrist.
   4. The commissioner shall submit each form received pursuant  to  this
 section  to the committee, except as otherwise provided in this subdivi-
 sion.  The committee shall review the forms and  shall  randomly  cross-
 check  such  submissions  with  a  publicly  available or other database
 containing electronic prescriber information. Should a database  of  all
 oral  therapeutic  pharmaceutical  agents  prescribed or used by optome-
 trists pursuant to section 7101-a of the education law become available,
 and the commissioner 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  section  7101-a  of the education law.   The committee
 shall advise the commissioner as to compliance with  the  provisions  of
 section  7101-a  of  the  education  law  for  the purpose of evaluating
 compliance with the provisions of section 7101-a of  the  education  law
 including the applicable referrals and dosing limitations and to identi-
 fy  any  necessary  enhancements to the curriculum provided for in para-
 graph (c) of subdivision 4 of section 7101-a of the  education  law  and
 other  educational  materials  and to assist in ensuring patient safety.
 Upon finding evidence of non-compliance by any optometrist, the  commit-
 tee  shall  refer such information to the commissioner and to the office

 A. 1193                             7
 
 of professions within the department for investigation and, if  applica-
 ble,  disciplinary  action.  Nothing  in this subdivision is intended to
 modify or otherwise limit the department's authority  or  discretion  to
 review,  investigate  and  refer  matters  related  to  the professional
 conduct of a licensed provider.
   § 14. This act shall take effect eighteen months after it  shall  have
 become a law; provided that:
   (a)  section  thirteen of this act shall expire and be deemed repealed
 five years following the approval by the department of education of  the
 initial  certification  course  or the initial examination, whichever is
 later, pursuant to paragraph (c) of subdivision 4 of section  7101-a  of
 the education law as added by section six of this act;
   (b)  the  commissioner  of education shall notify the legislative bill
 drafting commission upon approval of the  initial  certification  course
 and  examination  required  in section six of this act in order that the
 commission may maintain an accurate and timely effective  data  base  of
 the official text of the laws of the state of New York in furtherance of
 effectuating  the  provisions  of  section 44 of the legislative law and
 section 70-b of the public officers law; and
   (c) 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.

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1193--A
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 14, 2019
                                ___________
 
 Introduced  by  M.  of  A.  PAULIN, COOK, CYMBROWITZ, ABINANTI, GUNTHER,
   WEPRIN, HEVESI, RYAN, TITUS,  STIRPE,  BUCHWALD,  DiPIETRO,  BRABENEC,
   BLAKE,  FAHY, ORTIZ, COLTON, NORRIS, BARRETT, PHEFFER AMATO, DINOWITZ,
   LALOR, ZEBROWSKI, STECK,  HUNTER,  BRONSON,  SOLAGES,  PEOPLES-STOKES,
   DE LA ROSA,  B. MILLER, RAIA, GARBARINO, MORINELLO, FITZPATRICK, DICK-
   ENS, MAGNARELLI, PICHARDO, SANTABARBARA,  GIGLIO,  D. ROSENTHAL,  KIM,
   RODRIGUEZ,  ABBATE,  JONES, ARROYO, VANEL, McDONOUGH, AUBRY, L. ROSEN-
   THAL,  ENGLEBRIGHT,  LAVINE,  D'URSO,   JAFFEE,   JOYNER,   SEAWRIGHT,
   M. L. MILLER,  ASHBY,  FERNANDEZ,  FALL,  SMITH, BURKE, REILLY, REYES,
   SALKA, WALLACE,  JACOBSON,  JEAN-PIERRE,  MOSLEY,  MANKTELOW,  TAYLOR,
   BENEDETTO,  STERN,  GRIFFIN, CRESPO, BUTTENSCHON -- Multi-Sponsored by
   -- M. of A. BARCLAY, BLANKENBUSH,  CAHILL,  CARROLL,  CROUCH,  CUSICK,
   DAVILA,  EPSTEIN,  FRIEND,  GALEF, GOODELL, GOTTFRIED, HAWLEY, LENTOL,
   LIFTON, LUPARDO,  PALMESANO,  PERRY,  QUART,  RIVERA,  SIMOTAS,  STEC,
   TAGUE, THIELE, WALSH, WOERNER, WRIGHT -- read once and referred to the
   Committee  on  Higher Education -- 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
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Paragraph (e) of subdivision 1 of  section  7101-a  of  the
 education  law,  as added by chapter 517 of the laws of 1995, is amended
 to read as follows:
   (e) [Phase one] TOPICAL therapeutic pharmaceutical agents. [Phase one]
 TOPICAL THERAPEUTIC pharmaceutical agents shall mean those  drugs  which
 shall  be  limited  to topical application to the surface of the eye for
 therapeutic purposes and shall be limited to:
   (i) antibiotic/antimicrobials;
   (ii) decongestants/anti-allergenics;
   (iii) non-steroidal anti-inflammatory agents;

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

                                                            LBD01275-04-9

 A. 1193--A                          2
 
   (iv) steroidal anti-inflammatory agents;
   (v) antiviral agents;
   (vi) hyperosmotic/hypertonic agents;
   (vii) cycloplegics;
   (viii) artificial tears and lubricants; AND
   (IX) IMMUNOSUPPRESSIVE AGENTS.
   § 2. Paragraph (f) of subdivision 1 of section 7101-a of the education
 law,  as added by chapter 517 of the laws of 1995, is amended to read as
 follows:
   (f) [Phase two  therapeutic]  THERAPEUTIC  pharmaceutical  agents  FOR
 TREATMENT  OF GLAUCOMA AND OCULAR HYPERTENSION.  [Phase two] THERAPEUTIC
 pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR  HYPERTENSION
 shall  mean those drugs which shall be limited to topical application to
 the surface of the eye and shall be limited to:
   (i) beta blockers;
   (ii) alpha agonists;
   (iii) direct acting cholinergic agents;
   (IV) PROSTAGLANDIN ANALOGS; AND
   (V) CARBONIC ANHYDRASE INHIBITORS.
   § 3. Subdivision 1 of section 7101-a of the education law  is  amended
 by adding a new paragraph (g) to read as follows:
   (G)  ORAL  THERAPEUTIC PHARMACEUTICAL AGENTS. ORAL THERAPEUTIC PHARMA-
 CEUTICAL AGENTS SHALL MEAN THOSE  ORALLY  ADMINISTERED  DRUGS  USED  FOR
 THERAPEUTIC PURPOSES SOLELY FOR THE TREATMENT OF DISEASES OF THE EYE AND
 ADNEXA AND SHALL BE LIMITED TO:
   (I) ANTIBIOTICS;
   (II) DECONGESTANTS/ANTI-ALLERGENIC/ANTIHISTAMINES;
   (III)  ANTIGLAUCOMA  AGENTS USED FOR THE MANAGEMENT OF ACUTE INCREASES
 IN INTRAOCULAR PRESSURE; PROVIDED, HOWEVER, AN OPTOMETRIST  MAY  USE  OR
 PRESCRIBE A MAXIMUM OF ONE TWENTY-FOUR HOUR PRESCRIPTION AND SHALL IMME-
 DIATELY  REFER  THE  PATIENT  TO  A  LICENSED  PHYSICIAN SPECIALIZING IN
 DISEASES OF THE EYE;
   (IV) ANTIVIRAL AGENTS USED FOR HERPES ZOSTER OPHTHALMICUS; PROVIDED AN
 OPTOMETRIST  SHALL  USE  OR  PRESCRIBE   IN   MAXIMUM,   ONE   SEVEN-DAY
 PRESCRIPTION;  PROVIDED,  HOWEVER, IF A PATIENT IS DIAGNOSED WITH HERPES
 ZOSTER OPHTHALMICUS AND HAS NOT ALREADY BEEN EXAMINED BY A PRIMARY  CARE
 PHYSICIAN  OR  OTHER  APPROPRIATE PHYSICIAN FOR SUCH VIRAL CONDITION, AN
 OPTOMETRIST SHALL REFER THE PATIENT TO A LICENSED  PRIMARY  CARE  PHYSI-
 CIAN,  LICENSED  PHYSICIAN SPECIALIZING IN DISEASES OF THE EYE, OR OTHER
 APPROPRIATE PHYSICIAN WITHIN THREE DAYS OF SUCH DIAGNOSIS; AND
   (V) NON-STEROIDAL ANTI-INFLAMMATORY AGENTS.
   § 4. The subdivision heading and paragraph (a)  of  subdivision  4  of
 section 7101-a of the education law, as added by chapter 517 of the laws
 of 1995, are amended to read as follows:
   [Phase  one]  TOPICAL  therapeutic  pharmaceutical  agents. (a) Before
 using or prescribing  [phase  one]  TOPICAL  therapeutic  pharmaceutical
 agents,  each  optometrist  shall  have completed at least three hundred
 hours of clinical training in the diagnosis, treatment and management of
 patients with ocular disease other than glaucoma  and  ocular  hyperten-
 sion,  not fewer than twenty-five hours of such training shall have been
 completed subsequent to June thirtieth,  nineteen  hundred  ninety-three
 and  additionally  shall  either  have taken and successfully passed the
 treatment and management of ocular  diseases  portion  of  the  National
 Board  of  Examiners  in  Optometry  test or have taken and successfully
 passed an examination acceptable to the board.

 A. 1193--A                          3
 
   § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education
 law, as added by chapter 517 of the laws of 1995, is amended to read  as
 follows:
   (b) Before using or prescribing [phase two] therapeutic pharmaceutical
 agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION, an optometrist
 must  be  certified  for  diagnostic and [phase one] TOPICAL therapeutic
 agents and have completed an additional one hundred  hours  of  clinical
 training  in  the  diagnosis,  treatment and management of patients with
 glaucoma and ocular hypertension, not fewer than  twenty-five  hours  of
 such  training shall have been completed subsequent to July first, nine-
 teen hundred ninety-four, and shall have taken and  successfully  passed
 an oral or written examination acceptable by the board.
   §  6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of the
 education law are relettered paragraphs (d) and (e) and a new  paragraph
 (c) is added to read as follows:
   (C)  BEFORE  USING  OR  PRESCRIBING  ORAL  THERAPEUTIC  PHARMACEUTICAL
 AGENTS, AN OPTOMETRIST MUST BE CERTIFIED TO PRESCRIBE DIAGNOSTIC PHARMA-
 CEUTICAL AGENTS AND TOPICAL THERAPEUTIC AND  THERAPEUTIC  PHARMACEUTICAL
 AGENTS FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION, HAVE COMPLETED
 AN  ORAL  THERAPEUTIC PHARMACEUTICAL AGENT CERTIFICATION COURSE AND HAVE
 PASSED AN EXAMINATION WITHIN FIVE YEARS OF THE DEPARTMENT'S APPROVAL  OF
 THE  INITIAL  CERTIFICATION COURSE OR THE INITIAL EXAMINATION, WHICHEVER
 IS LATER PROVIDED, HOWEVER, AN OPTOMETRIST WHO HAS  COMMENCED  THE  ORAL
 THERAPEUTIC  PHARMACEUTICAL  AGENT  CERTIFICATION COURSE WITHIN THE FIVE
 YEAR TIME PERIOD BUT HAS NOT YET PASSED AN EXAMINATION SHALL BE  ALLOWED
 TO  TAKE  SUCH EXAMINATION AND BECOME CERTIFIED AFTER THE FIVE YEAR TIME
 PERIOD PROVIDED FOR IN THIS PARAGRAPH HAS ENDED.
   (I) THE CURRICULUM  FOR  THE  ORAL  THERAPEUTIC  PHARMACEUTICAL  AGENT
 CERTIFICATION  COURSE  SHALL INCLUDE, BUT NOT BE LIMITED TO, INSTRUCTION
 IN PHARMACOLOGY AND DRUG INTERACTION IN TREATING OCULAR DISEASE  AND  BE
 TAUGHT  THROUGH  CLINICAL CASE SCENARIOS AND EMPHASIZE CLINICAL DECISION
 MAKING AND SHALL BE NO LESS THAN FORTY HOURS,  OF  WHICH  NO  LESS  THAN
 TWENTY-FOUR HOURS SHALL BE LIVE INSTRUCTION.
   (II)  SUCH  COURSE SHALL QUALIFY TOWARDS MEETING THE CONTINUING EDUCA-
 TION PER TRIENNIAL  REGISTRATION  REQUIREMENT  PURSUANT  TO  SUBDIVISION
 SEVEN OF THIS SECTION.
   (III)  THE  EXAMINATION SHALL ASSESS THE KNOWLEDGE OF MATERIALS IN THE
 CURRICULUM  AND  REFLECT  THE  ORAL  THERAPEUTIC  PHARMACEUTICAL  AGENTS
 DESCRIBED IN PARAGRAPH (G) OF SUBDIVISION ONE OF THIS SECTION, AND SHALL
 BE ACCEPTABLE TO THE DEPARTMENT.
   (IV) THE INITIAL, AND ANY SUBSEQUENT, CURRICULUM AND EXAMINATION SHALL
 BE SUBJECT TO REVIEW AND APPROVAL BY THE DEPARTMENT.
   (V)  THE  REQUIREMENT  FOR  THE  ORAL THERAPEUTIC PHARMACEUTICAL AGENT
 CERTIFICATION COURSE AND EXAMINATION SHALL NOT APPLY  TO  THOSE  OPTOME-
 TRISTS  WHO GRADUATED FROM AN ACCREDITED COLLEGE OF OPTOMETRY SUBSEQUENT
 TO JANUARY FIRST, TWO THOUSAND SEVEN AND  HAVE  TAKEN  AND  SUCCESSFULLY
 PASSED  THE  NATIONAL  BOARD OF EXAMINERS IN OPTOMETRY EXAMINATION OR AN
 EXAMINATION ACCEPTABLE TO THE DEPARTMENT.
   § 7. Subdivision 5 of section 7101-a of the education law, as added by
 chapter 517 of the laws of 1995, is amended to read as follows:
   5. Suspension of  certification.  The  department  shall  suspend  the
 certification  for the use and prescribing of [phase one] TOPICAL thera-
 peutic agents of any optometrist who fails to receive certification  for
 [phase  two] therapeutic pharmaceutical agents FOR TREATMENT OF GLAUCOMA
 AND OCULAR HYPERTENSION within three years of having been certified  for
 [phase one] TOPICAL therapeutic pharmaceutical agents.

 A. 1193--A                          4
 
   § 8. The subdivision heading of subdivision 6 of section 7101-a of the
 education  law,  as added by chapter 517 of the laws of 1995, is amended
 to read as follows:
   Consultation  WITH  USE  OF CERTAIN TOPICAL THERAPEUTIC PHARMACEUTICAL
 AGENTS FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION.
   § 9. Subdivision 7 of section 7101-a of the education law, as added by
 chapter 517 of the laws of 1995, is amended to read as follows:
   7. Continuing education. (A) Each optometrist certified to use  [phase
 one  or  phase two] TOPICAL THERAPEUTIC PHARMACEUTICAL AGENTS AND thera-
 peutic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPER-
 TENSION, shall complete a minimum  of  thirty-six  hours  of  continuing
 education  IN  THE AREA OF OCULAR DISEASE AND PHARMACOLOGY per triennial
 registration period. [The education shall  be  in  the  area  of  ocular
 disease  and  pharmacology  and  may  include both didactic and clinical
 components.] EACH OPTOMETRIST CERTIFIED TO USE ORAL THERAPEUTIC  PHARMA-
 CEUTICAL  AGENTS  SHALL,  IN ADDITION TO THE MINIMUM THIRTY-SIX HOURS OF
 CONTINUING EDUCATION PROVIDED FOR IN THIS SUBDIVISION, COMPLETE AN ADDI-
 TIONAL MINIMUM OF EIGHTEEN HOURS  OF  CONTINUING  EDUCATION  RELATED  TO
 SYSTEMIC  DISEASE  AND  THERAPEUTIC TREATMENT PER TRIENNIAL REGISTRATION
 PERIOD. Such educational programs MAY INCLUDE BOTH DIDACTIC AND CLINICAL
 COMPONENTS AND shall be approved  in  advance  by  the  department  [and
 evidence  of  the completion of this requirement shall be submitted with
 each application for license renewal as required by  section  sixty-five
 hundred  two  of this chapter]. BEGINNING ON JANUARY FIRST, TWO THOUSAND
 TWENTY-TWO,  ALL  SPONSORS  OF  CONTINUING  EDUCATION  COURSES   SEEKING
 ADVANCED  APPROVAL FROM THE DEPARTMENT SHALL FILE AN APPLICATION AND PAY
 A FEE DETERMINED BY THE DEPARTMENT IN ACCORDANCE WITH THE REGULATIONS OF
 THE COMMISSIONER. AN OPTOMETRIST  SUBJECT  TO  THE  PROVISIONS  OF  THIS
 SUBDIVISION  WHOSE  FIRST REGISTRATION DATE FOLLOWING THE EFFECTIVE DATE
 OF THIS SECTION OCCURS LESS THAN THREE YEARS FROM SUCH  EFFECTIVE  DATE,
 BUT  ON  OR AFTER JANUARY FIRST, TWO THOUSAND TWENTY-TWO, SHALL COMPLETE
 CONTINUING EDUCATION HOURS ON A PRORATED BASIS AT THE RATE OF  ONE  HOUR
 PER  MONTH  FOR THE PERIOD BEGINNING JANUARY FIRST, TWO THOUSAND TWENTY-
 TWO UP TO THE FIRST REGISTRATION DATE THEREAFTER. AN OPTOMETRIST WHO HAS
 NOT SATISFIED THE MANDATORY CONTINUING EDUCATION REQUIREMENT PURSUANT TO
 THIS SUBDIVISION SHALL NOT BE ISSUED A  TRIENNIAL  REGISTRATION  CERTIF-
 ICATE BY THE DEPARTMENT AND SHALL NOT PRACTICE UNLESS AND UNTIL A CONDI-
 TIONAL  REGISTRATION  IS ISSUED AS PROVIDED FOR IN PARAGRAPH (B) OF THIS
 SUBDIVISION. CONTINUING EDUCATION HOURS TAKEN DURING ONE  TRIENNIUM  MAY
 NOT BE TRANSFERRED TO THE SUBSEQUENT TRIENNIUM.
   (B)  THE DEPARTMENT, IN ITS DISCRETION, MAY ISSUE A CONDITIONAL REGIS-
 TRATION TO AN OPTOMETRIST WHO FAILS TO  MEET  THE  CONTINUING  EDUCATION
 REQUIREMENTS  ESTABLISHED  IN PARAGRAPH (A) OF THIS SUBDIVISION, BUT WHO
 AGREES TO MAKE UP ANY DEFICIENCIES AND COMPLETE ANY ADDITIONAL EDUCATION
 WHICH THE DEPARTMENT MAY REQUIRE. THE FEE FOR SUCH A CONDITIONAL  REGIS-
 TRATION SHALL BE THE SAME AS, AND IN ADDITION TO, THE FEE FOR THE TRIEN-
 NIAL  REGISTRATION.  THE DURATION OF SUCH CONDITIONAL REGISTRATION SHALL
 BE DETERMINED BY THE DEPARTMENT, BUT SHALL  NOT  EXCEED  ONE  YEAR.  ANY
 OPTOMETRIST WHO IS NOTIFIED OF THE DENIAL OF REGISTRATION FOR FAILURE TO
 SUBMIT  EVIDENCE, SATISFACTORY TO THE DEPARTMENT, OF REQUIRED CONTINUING
 EDUCATION AND WHO PRACTICES WITHOUT SUCH REGISTRATION MAY BE SUBJECT  TO
 DISCIPLINARY  PROCEEDINGS  PURSUANT TO SECTION SIXTY-FIVE HUNDRED TEN OF
 THIS TITLE.
   (C) IN ACCORDANCE WITH THE INTENT OF THIS SECTION, ADJUSTMENT  TO  THE
 MANDATORY CONTINUING EDUCATION REQUIREMENT MAY BE GRANTED BY THE DEPART-
 MENT  FOR  REASONS OF HEALTH THAT ARE CERTIFIED BY AN APPROPRIATE HEALTH

 A. 1193--A                          5
 
 CARE PROFESSIONAL, FOR EXTENDED ACTIVE DUTY WITH THE ARMED FORCES OF THE
 UNITED STATES, OR FOR OTHER GOOD  CAUSE  ACCEPTABLE  TO  THE  DEPARTMENT
 WHICH MAY PREVENT COMPLIANCE.
   (D)  AN  OPTOMETRIST  NOT  ENGAGED  IN  PRACTICE, AS DETERMINED BY THE
 DEPARTMENT, SHALL BE EXEMPT  FROM  THE  MANDATORY  CONTINUING  EDUCATION
 REQUIREMENT UPON THE FILING OF A STATEMENT WITH THE DEPARTMENT DECLARING
 SUCH  STATUS.  ANY  LICENSEE  WHO  RETURNS  TO THE PRACTICE OF OPTOMETRY
 DURING THE TRIENNIAL REGISTRATION PERIOD  SHALL  NOTIFY  THE  DEPARTMENT
 PRIOR TO REENTERING THE PROFESSION AND SHALL MEET SUCH CONTINUING EDUCA-
 TION  REQUIREMENTS  AS SHALL BE PRESCRIBED BY REGULATIONS OF THE COMMIS-
 SIONER.
   (E) OPTOMETRISTS SUBJECT TO THE PROVISIONS OF THIS  SUBDIVISION  SHALL
 MAINTAIN  ADEQUATE  DOCUMENTATION OF COMPLETION OF ACCEPTABLE CONTINUING
 EDUCATION CREDITS AND SHALL PROVIDE SUCH DOCUMENTATION AT THE REQUEST OF
 THE DEPARTMENT. FAILURE TO PROVIDE SUCH DOCUMENTATION UPON  THE  REQUEST
 OF  THE DEPARTMENT SHALL BE AN ACT OF MISCONDUCT SUBJECT TO DISCIPLINARY
 PROCEEDINGS PURSUANT TO SECTION SIXTY-FIVE HUNDRED TEN OF THIS TITLE.
   (F) THE MANDATORY CONTINUING EDUCATION FEE SHALL BE DETERMINED BY  THE
 DEPARTMENT.    SUCH  FEE  SHALL BE PAYABLE ON OR BEFORE THE FIRST DAY OF
 EACH TRIENNIAL REGISTRATION PERIOD, AND SHALL BE PAID IN ADDITION TO THE
 TRIENNIAL REGISTRATION FEE REQUIRED  BY  SUBDIVISION  EIGHT  OF  SECTION
 SEVENTY-ONE HUNDRED FOUR OF THIS ARTICLE.
   § 10. The subdivision heading and subparagraph (i) of paragraph (a) of
 subdivision  8 of section 7101-a of the education law, as added by chap-
 ter 517 of the laws of 1995, are amended to read as follows:
   Notice to patient WITH THE USE OR PRESCRIPTION OF TOPICAL  THERAPEUTIC
 PHARMACEUTICAL  AGENTS  AND THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREAT-
 MENT OF GLAUCOMA AND OCULAR HYPERTENSION.
   (i) An optometrist prescribing TOPICAL steroids or  antiviral  medica-
 tion  shall inform each patient that in the event the condition does not
 improve within five days, a physician of the patient's  choice  will  be
 notified.
   §  11. Subdivision 10 of section 7101-a of the education law, as added
 by chapter 517 of the laws of 1995, is amended to read as follows:
   10. Pharmaceutical agents. Optometrists who  have  been  approved  and
 certified  by  the  department  shall  be permitted to use the following
 drugs:
   (a) Diagnostic pharmaceuticals.
   (b) Those optometrists having been certified for [phase  one]  TOPICAL
 therapeutic  pharmaceutical  agents  shall be authorized [(i) to use and
 recommend all nonprescription medications appropriate for ocular disease
 whether intended for topical or oral use; and (ii)] to use and prescribe
 all [phase one] TOPICAL therapeutic pharmaceutical agents  SPECIFIED  IN
 PARAGRAPH (E) OF SUBDIVISION ONE OF THIS SECTION, which are FDA approved
 and commercially available FOR TOPICAL USE.
   In the event an optometrist treats a patient with topical antiviral or
 steroidal  drugs  and the patient's condition either fails to improve or
 worsens within five days,  the  optometrist  shall  notify  a  physician
 designated by the patient or, if none, by the treating optometrist.
   (c) Those optometrists having been certified for [phase two] therapeu-
 tic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTEN-
 SION  shall  be  authorized to use and prescribe [phase two] therapeutic
 pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR  HYPERTENSION
 SPECIFIED IN PARAGRAPH (F) OF SUBDIVISION ONE OF THIS SECTION, which are
 FDA approved and commercially available.

 A. 1193--A                          6
 
   (D)  THOSE  OPTOMETRISTS  HAVING  BEEN  CERTIFIED FOR ORAL THERAPEUTIC
 PHARMACEUTICAL AGENTS SHALL BE AUTHORIZED  TO  USE  AND  PRESCRIBE  ORAL
 THERAPEUTIC PHARMACEUTICAL AGENTS SPECIFIED IN PARAGRAPH (G) OF SUBDIVI-
 SION ONE OF THIS SECTION, WHICH ARE FDA APPROVED AND COMMERCIALLY AVAIL-
 ABLE  AND  SHALL  COMPLY WITH ALL SAFETY INFORMATION AND SIDE-EFFECT AND
 WARNING ADVISORIES CONTAINED IN THE MOST CURRENT PHYSICIANS' DESK REFER-
 ENCE.
   (E) THOSE OPTOMETRISTS HAVING BEEN CERTIFIED FOR  TOPICAL  THERAPEUTIC
 PHARMACEUTICAL  AGENTS,  THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREATMENT
 OF GLAUCOMA AND OCULAR HYPERTENSION OR 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.
   §  12.  Subdivision 8 of section 7104 of the education law, as amended
 by chapter 517 of the laws of 1995, is amended to read as follows:
   (8) Fees: pay a fee of two hundred twenty dollars  to  the  department
 for  admission  to a department conducted examination and for an initial
 license, a fee of one hundred fifteen dollars for each reexamination,  a
 fee  of  one  hundred  thirty-five  dollars  for  an initial license for
 persons not requiring admission to a department  conducted  examination,
 [and]  a  fee of two hundred ten dollars for each triennial registration
 period, [and] for additional authorization for the purpose of  utilizing
 diagnostic  pharmaceutical  agents,  a  fee  of  sixty  dollars, AND FOR
 CERTIFICATION  TO  USE  OR  PRESCRIBE  ORAL  THERAPEUTIC  PHARMACEUTICAL
 AGENTS, A FEE OF TWO HUNDRED FIFTY DOLLARS.
   §  13. 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 Janu-
 ary 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.

                            
 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1193--B
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 14, 2019
                                ___________
 
 Introduced  by  M.  of  A.  PAULIN, COOK, CYMBROWITZ, ABINANTI, GUNTHER,
   WEPRIN, HEVESI, RYAN, TITUS,  STIRPE,  BUCHWALD,  DiPIETRO,  BRABENEC,
   BLAKE,  FAHY, ORTIZ, COLTON, NORRIS, BARRETT, PHEFFER AMATO, DINOWITZ,
   LALOR, ZEBROWSKI, STECK,  HUNTER,  BRONSON,  SOLAGES,  PEOPLES-STOKES,
   DE LA ROSA,  B. MILLER, RAIA, GARBARINO, MORINELLO, FITZPATRICK, DICK-
   ENS, MAGNARELLI, PICHARDO, SANTABARBARA,  GIGLIO,  D. ROSENTHAL,  KIM,
   RODRIGUEZ,  ABBATE,  JONES, ARROYO, VANEL, McDONOUGH, AUBRY, L. ROSEN-
   THAL,  ENGLEBRIGHT,  LAVINE,  D'URSO,   JAFFEE,   JOYNER,   SEAWRIGHT,
   M. L. MILLER,  FERNANDEZ,  FALL, BURKE, REILLY, REYES, SALKA, WALLACE,
   JACOBSON, JEAN-PIERRE, MOSLEY, MANKTELOW,  TAYLOR,  BENEDETTO,  STERN,
   GRIFFIN,  CRESPO, BUTTENSCHON, MALLIOTAKIS, EICHENSTEIN -- Multi-Spon-
   sored by -- M. of A. BARCLAY, BLANKENBUSH,  CAHILL,  CARROLL,  CROUCH,
   CUSICK,  DAVILA,  EPSTEIN,  FRIEND, GALEF, GOODELL, GOTTFRIED, HAWLEY,
   LENTOL, LIFTON, LUPARDO, PALMESANO,  PERRY,  QUART,  RIVERA,  SIMOTAS,
   STEC,  TAGUE, THIELE, WALSH, WOERNER, WRIGHT -- read once and referred
   to the Committee on Higher Education  --  committee  discharged,  bill
   amended,  ordered reprinted as amended and recommitted to said commit-
   tee -- again reported from said  committee  with  amendments,  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
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  (e)  of subdivision 1 of section 7101-a of the
 education law, as added by chapter 517 of the laws of 1995,  is  amended
 to read as follows:
   (e) [Phase one] TOPICAL therapeutic pharmaceutical agents. [Phase one]
 TOPICAL  THERAPEUTIC  pharmaceutical agents shall mean those drugs which
 shall be limited to topical application to the surface of  the  eye  for
 therapeutic purposes and shall be limited to:
   (i) antibiotic/antimicrobials;

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

                                                            LBD01275-08-9

 A. 1193--B                          2
 
   (ii) decongestants/anti-allergenics;
   (iii) non-steroidal anti-inflammatory agents;
   (iv) steroidal anti-inflammatory agents;
   (v) antiviral agents;
   (vi) hyperosmotic/hypertonic agents;
   (vii) cycloplegics;
   (viii) artificial tears and lubricants; AND
   (IX) IMMUNOSUPPRESSIVE AGENTS.
   § 2. Paragraph (f) of subdivision 1 of section 7101-a of the education
 law,  as added by chapter 517 of the laws of 1995, is amended to read as
 follows:
   (f) [Phase two  therapeutic]  THERAPEUTIC  pharmaceutical  agents  FOR
 TREATMENT  OF GLAUCOMA AND OCULAR HYPERTENSION.  [Phase two] THERAPEUTIC
 pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR  HYPERTENSION
 shall  mean those drugs which shall be limited to topical application to
 the surface of the eye and shall be limited to:
   (i) beta blockers;
   (ii) alpha agonists;
   (iii) direct acting cholinergic agents;
   (IV) PROSTAGLANDIN ANALOGS; AND
   (V) CARBONIC ANHYDRASE INHIBITORS.
   § 3. Subdivision 1 of section 7101-a of the education law  is  amended
 by adding a new paragraph (g) to read as follows:
   (G)  ORAL  THERAPEUTIC PHARMACEUTICAL AGENTS. ORAL THERAPEUTIC PHARMA-
 CEUTICAL AGENTS SHALL MEAN THOSE  ORALLY  ADMINISTERED  DRUGS  USED  FOR
 THERAPEUTIC PURPOSES SOLELY FOR THE TREATMENT OF DISEASES OF THE EYE AND
 ADNEXA AND SHALL BE LIMITED TO:
   (I) THE FOLLOWING ANTIBIOTICS:
   (1) AMOXICILLIN/CLAVULANATE POTASSIUM;
   (2) CEPHALEXIN;
   (3) AZITHROMYCIN;
   (4) SULFAMETHOXAZOLE/TRIMETHOPRIM;
   (5) DOXYCYCLINE; AND
   (6) TETRACYCLINE;
   (II)  THE  FOLLOWING  ANTIGLAUCOMA  AGENTS  USED FOR THE MANAGEMENT OF
 ACUTE INCREASES IN INTRAOCULAR PRESSURE; PROVIDED, HOWEVER,  AN  OPTOME-
 TRIST   MAY   USE  OR  PRESCRIBE  A  MAXIMUM  OF  ONE  TWENTY-FOUR  HOUR
 PRESCRIPTION AND SHALL IMMEDIATELY  REFER  THE  PATIENT  TO  A  LICENSED
 PHYSICIAN SPECIALIZING IN DISEASES OF THE EYE:
   (1) ACETAZOLAMIDE; AND
   (2) METHAZOLAMIDE; AND
   (III) THE FOLLOWING ANTIVIRAL AGENTS USED FOR HERPES ZOSTER OPHTHALMI-
 CUS;  PROVIDED  AN  OPTOMETRIST  SHALL  USE OR PRESCRIBE IN MAXIMUM, ONE
 SEVEN-DAY PRESCRIPTION; PROVIDED, HOWEVER, IF  A  PATIENT  IS  DIAGNOSED
 WITH  HERPES  ZOSTER OPHTHALMICUS AND HAS NOT ALREADY BEEN EXAMINED BY A
 PRIMARY CARE PHYSICIAN OR OTHER APPROPRIATE  PHYSICIAN  FOR  SUCH  VIRAL
 CONDITION,  AN OPTOMETRIST SHALL REFER THE PATIENT TO A LICENSED PRIMARY
 CARE PHYSICIAN, LICENSED PHYSICIAN SPECIALIZING IN DISEASES OF THE  EYE,
 OR OTHER APPROPRIATE PHYSICIAN WITHIN THREE DAYS OF SUCH DIAGNOSIS:
   (1) VALACYCLOVIR; AND
   (2) ACYCLOVIR.
   §  4.  The  subdivision  heading and paragraph (a) of subdivision 4 of
 section 7101-a of the education law, as added by chapter 517 of the laws
 of 1995, are amended to read as follows:
   [Phase one] TOPICAL  therapeutic  pharmaceutical  agents.  (a)  Before
 using  or  prescribing  [phase  one]  TOPICAL therapeutic pharmaceutical

 A. 1193--B                          3
 
 agents, each optometrist shall have completed  at  least  three  hundred
 hours of clinical training in the diagnosis, treatment and management of
 patients  with  ocular  disease other than glaucoma and ocular hyperten-
 sion,  not fewer than twenty-five hours of such training shall have been
 completed subsequent to June thirtieth,  nineteen  hundred  ninety-three
 and  additionally  shall  either  have taken and successfully passed the
 treatment and management of ocular  diseases  portion  of  the  National
 Board  of  Examiners  in  Optometry  test or have taken and successfully
 passed an examination acceptable to the board.
   § 5. Paragraph (b) of subdivision 4 of section 7101-a of the education
 law, as added by chapter 517 of the laws of 1995, is amended to read  as
 follows:
   (b) Before using or prescribing [phase two] therapeutic pharmaceutical
 agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION, an optometrist
 must  be  certified  for  diagnostic and [phase one] TOPICAL therapeutic
 agents and have completed an additional one hundred  hours  of  clinical
 training  in  the  diagnosis,  treatment and management of patients with
 glaucoma and ocular hypertension, not fewer than  twenty-five  hours  of
 such  training shall have been completed subsequent to July first, nine-
 teen hundred ninety-four, and shall have taken and  successfully  passed
 an oral or written examination acceptable by the board.
   §  6. Paragraphs (c) and (d) of subdivision 4 of section 7101-a of the
 education law are relettered paragraphs (d) and (e) and a new  paragraph
 (c) is added to read as follows:
   (C)  BEFORE  USING  OR  PRESCRIBING  ORAL  THERAPEUTIC  PHARMACEUTICAL
 AGENTS, AN OPTOMETRIST MUST BE CERTIFIED TO PRESCRIBE DIAGNOSTIC PHARMA-
 CEUTICAL AGENTS AND TOPICAL THERAPEUTIC AND  THERAPEUTIC  PHARMACEUTICAL
 AGENTS FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION, HAVE COMPLETED
 AN  ORAL  THERAPEUTIC PHARMACEUTICAL AGENT CERTIFICATION COURSE AND HAVE
 PASSED AN EXAMINATION WITHIN FIVE YEARS OF THE DEPARTMENT'S APPROVAL  OF
 THE  INITIAL  CERTIFICATION COURSE OR THE INITIAL EXAMINATION, WHICHEVER
 IS LATER PROVIDED, HOWEVER, AN OPTOMETRIST WHO HAS  COMMENCED  THE  ORAL
 THERAPEUTIC  PHARMACEUTICAL  AGENT  CERTIFICATION COURSE WITHIN THE FIVE
 YEAR TIME PERIOD BUT HAS NOT YET PASSED AN EXAMINATION SHALL BE  ALLOWED
 TO  TAKE  SUCH EXAMINATION AND BECOME CERTIFIED AFTER THE FIVE YEAR TIME
 PERIOD PROVIDED FOR IN THIS PARAGRAPH HAS ENDED.
   (I) THE CURRICULUM  FOR  THE  ORAL  THERAPEUTIC  PHARMACEUTICAL  AGENT
 CERTIFICATION  COURSE  SHALL INCLUDE, BUT NOT BE LIMITED TO, INSTRUCTION
 IN PHARMACOLOGY AND DRUG INTERACTION IN TREATING OCULAR DISEASE  AND  BE
 TAUGHT  THROUGH  CLINICAL CASE SCENARIOS AND EMPHASIZE CLINICAL DECISION
 MAKING AND SHALL BE NO LESS THAN FORTY HOURS,  OF  WHICH  NO  LESS  THAN
 TWENTY-FOUR HOURS SHALL BE LIVE INSTRUCTION.
   (II)  SUCH  COURSE SHALL QUALIFY TOWARDS MEETING THE CONTINUING EDUCA-
 TION PER TRIENNIAL  REGISTRATION  REQUIREMENT  PURSUANT  TO  SUBDIVISION
 SEVEN OF THIS SECTION.
   (III)  THE  EXAMINATION SHALL ASSESS THE KNOWLEDGE OF MATERIALS IN THE
 CURRICULUM  AND  REFLECT  THE  ORAL  THERAPEUTIC  PHARMACEUTICAL  AGENTS
 DESCRIBED IN PARAGRAPH (G) OF SUBDIVISION ONE OF THIS SECTION, AND SHALL
 BE ACCEPTABLE TO THE DEPARTMENT.
   (IV) THE INITIAL, AND ANY SUBSEQUENT, CURRICULUM AND EXAMINATION SHALL
 BE SUBJECT TO REVIEW AND APPROVAL BY THE DEPARTMENT.
   (V)  THE  REQUIREMENT  FOR  THE  ORAL THERAPEUTIC PHARMACEUTICAL AGENT
 CERTIFICATION COURSE AND EXAMINATION SHALL NOT APPLY  TO  THOSE  OPTOME-
 TRISTS  WHO GRADUATED FROM AN ACCREDITED COLLEGE OF OPTOMETRY SUBSEQUENT
 TO JANUARY FIRST, TWO THOUSAND SEVEN AND  HAVE  TAKEN  AND  SUCCESSFULLY

 A. 1193--B                          4
 
 PASSED  THE  NATIONAL  BOARD OF EXAMINERS IN OPTOMETRY EXAMINATION OR AN
 EXAMINATION ACCEPTABLE TO THE DEPARTMENT.
   § 7. Subdivision 5 of section 7101-a of the education law, as added by
 chapter 517 of the laws of 1995, is amended to read as follows:
   5.  Suspension  of  certification.  The  department  shall suspend the
 certification for the use and prescribing of [phase one] TOPICAL  thera-
 peutic  agents of any optometrist who fails to receive certification for
 [phase two] therapeutic pharmaceutical agents FOR TREATMENT OF  GLAUCOMA
 AND  OCULAR HYPERTENSION within three years of having been certified for
 [phase one] TOPICAL therapeutic pharmaceutical agents.
   § 8. The subdivision heading of subdivision 6 of section 7101-a of the
 education law, as added by chapter 517 of the laws of 1995,  is  amended
 to read as follows:
   Consultation  WITH  USE  OF CERTAIN TOPICAL THERAPEUTIC PHARMACEUTICAL
 AGENTS FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTENSION.
   § 9. Subdivision 7 of section 7101-a of the education law, as added by
 chapter 517 of the laws of 1995, is amended to read as follows:
   7. Continuing education. (A) Each optometrist certified to use  [phase
 one  or  phase two] TOPICAL THERAPEUTIC PHARMACEUTICAL AGENTS AND thera-
 peutic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPER-
 TENSION, shall complete a minimum  of  thirty-six  hours  of  continuing
 education  IN  THE AREA OF OCULAR DISEASE AND PHARMACOLOGY per triennial
 registration period. [The education shall  be  in  the  area  of  ocular
 disease  and  pharmacology  and  may  include both didactic and clinical
 components.] EACH OPTOMETRIST CERTIFIED TO USE ORAL THERAPEUTIC  PHARMA-
 CEUTICAL  AGENTS  SHALL,  IN ADDITION TO THE MINIMUM THIRTY-SIX HOURS OF
 CONTINUING EDUCATION PROVIDED FOR IN THIS SUBDIVISION, COMPLETE AN ADDI-
 TIONAL MINIMUM OF EIGHTEEN HOURS  OF  CONTINUING  EDUCATION  RELATED  TO
 SYSTEMIC  DISEASE  AND  THERAPEUTIC TREATMENT PER TRIENNIAL REGISTRATION
 PERIOD. Such educational programs MAY INCLUDE BOTH DIDACTIC AND CLINICAL
 COMPONENTS AND shall be approved  in  advance  by  the  department  [and
 evidence  of  the completion of this requirement shall be submitted with
 each application for license renewal as required by  section  sixty-five
 hundred  two  of this chapter]. BEGINNING ON JANUARY FIRST, TWO THOUSAND
 TWENTY-TWO,  ALL  SPONSORS  OF  CONTINUING  EDUCATION  COURSES   SEEKING
 ADVANCED  APPROVAL FROM THE DEPARTMENT SHALL FILE AN APPLICATION AND PAY
 A FEE DETERMINED BY THE DEPARTMENT IN ACCORDANCE WITH THE REGULATIONS OF
 THE COMMISSIONER. AN OPTOMETRIST  SUBJECT  TO  THE  PROVISIONS  OF  THIS
 SUBDIVISION  WHOSE  FIRST REGISTRATION DATE FOLLOWING THE EFFECTIVE DATE
 OF THIS SECTION OCCURS LESS THAN THREE YEARS FROM SUCH  EFFECTIVE  DATE,
 BUT  ON  OR AFTER JANUARY FIRST, TWO THOUSAND TWENTY-TWO, SHALL COMPLETE
 CONTINUING EDUCATION HOURS ON A PRORATED BASIS AT THE RATE OF  ONE  HOUR
 PER  MONTH  FOR THE PERIOD BEGINNING JANUARY FIRST, TWO THOUSAND TWENTY-
 TWO UP TO THE FIRST REGISTRATION DATE THEREAFTER. AN OPTOMETRIST WHO HAS
 NOT SATISFIED THE MANDATORY CONTINUING EDUCATION REQUIREMENT PURSUANT TO
 THIS SUBDIVISION SHALL NOT BE ISSUED A  TRIENNIAL  REGISTRATION  CERTIF-
 ICATE BY THE DEPARTMENT AND SHALL NOT PRACTICE UNLESS AND UNTIL A CONDI-
 TIONAL  REGISTRATION  IS ISSUED AS PROVIDED FOR IN PARAGRAPH (B) OF THIS
 SUBDIVISION. CONTINUING EDUCATION HOURS TAKEN DURING ONE  TRIENNIUM  MAY
 NOT BE TRANSFERRED TO THE SUBSEQUENT TRIENNIUM.
   (B)  THE DEPARTMENT, IN ITS DISCRETION, MAY ISSUE A CONDITIONAL REGIS-
 TRATION TO AN OPTOMETRIST WHO FAILS TO  MEET  THE  CONTINUING  EDUCATION
 REQUIREMENTS  ESTABLISHED  IN PARAGRAPH (A) OF THIS SUBDIVISION, BUT WHO
 AGREES TO MAKE UP ANY DEFICIENCIES AND COMPLETE ANY ADDITIONAL EDUCATION
 WHICH THE DEPARTMENT MAY REQUIRE. THE FEE FOR SUCH A CONDITIONAL  REGIS-
 TRATION SHALL BE THE SAME AS, AND IN ADDITION TO, THE FEE FOR THE TRIEN-

 A. 1193--B                          5
 
 NIAL  REGISTRATION.  THE DURATION OF SUCH CONDITIONAL REGISTRATION SHALL
 BE DETERMINED BY THE DEPARTMENT, BUT SHALL  NOT  EXCEED  ONE  YEAR.  ANY
 OPTOMETRIST WHO IS NOTIFIED OF THE DENIAL OF REGISTRATION FOR FAILURE TO
 SUBMIT  EVIDENCE, SATISFACTORY TO THE DEPARTMENT, OF REQUIRED CONTINUING
 EDUCATION AND WHO PRACTICES WITHOUT SUCH REGISTRATION MAY BE SUBJECT  TO
 DISCIPLINARY  PROCEEDINGS  PURSUANT TO SECTION SIXTY-FIVE HUNDRED TEN OF
 THIS TITLE.
   (C) IN ACCORDANCE WITH THE INTENT OF THIS SECTION, ADJUSTMENT  TO  THE
 MANDATORY CONTINUING EDUCATION REQUIREMENT MAY BE GRANTED BY THE DEPART-
 MENT  FOR  REASONS OF HEALTH THAT ARE CERTIFIED BY AN APPROPRIATE HEALTH
 CARE PROFESSIONAL, FOR EXTENDED ACTIVE DUTY WITH THE ARMED FORCES OF THE
 UNITED STATES, OR FOR OTHER GOOD  CAUSE  ACCEPTABLE  TO  THE  DEPARTMENT
 WHICH MAY PREVENT COMPLIANCE.
   (D)  AN  OPTOMETRIST  NOT  ENGAGED  IN  PRACTICE, AS DETERMINED BY THE
 DEPARTMENT, SHALL BE EXEMPT  FROM  THE  MANDATORY  CONTINUING  EDUCATION
 REQUIREMENT UPON THE FILING OF A STATEMENT WITH THE DEPARTMENT DECLARING
 SUCH  STATUS.  ANY  LICENSEE  WHO  RETURNS  TO THE PRACTICE OF OPTOMETRY
 DURING THE TRIENNIAL REGISTRATION PERIOD  SHALL  NOTIFY  THE  DEPARTMENT
 PRIOR TO REENTERING THE PROFESSION AND SHALL MEET SUCH CONTINUING EDUCA-
 TION  REQUIREMENTS  AS SHALL BE PRESCRIBED BY REGULATIONS OF THE COMMIS-
 SIONER.
   (E) OPTOMETRISTS SUBJECT TO THE PROVISIONS OF THIS  SUBDIVISION  SHALL
 MAINTAIN  ADEQUATE  DOCUMENTATION OF COMPLETION OF ACCEPTABLE CONTINUING
 EDUCATION CREDITS AND SHALL PROVIDE SUCH DOCUMENTATION AT THE REQUEST OF
 THE DEPARTMENT. FAILURE TO PROVIDE SUCH DOCUMENTATION UPON  THE  REQUEST
 OF  THE DEPARTMENT SHALL BE AN ACT OF MISCONDUCT SUBJECT TO DISCIPLINARY
 PROCEEDINGS PURSUANT TO SECTION SIXTY-FIVE HUNDRED TEN OF THIS TITLE.
   (F) THE MANDATORY CONTINUING EDUCATION FEE SHALL BE DETERMINED BY  THE
 DEPARTMENT.    SUCH  FEE  SHALL BE PAYABLE ON OR BEFORE THE FIRST DAY OF
 EACH TRIENNIAL REGISTRATION PERIOD, AND SHALL BE PAID IN ADDITION TO THE
 TRIENNIAL REGISTRATION FEE REQUIRED  BY  SUBDIVISION  EIGHT  OF  SECTION
 SEVENTY-ONE HUNDRED FOUR OF THIS ARTICLE.
   § 10. The subdivision heading and subparagraph (i) of paragraph (a) of
 subdivision  8 of section 7101-a of the education law, as added by chap-
 ter 517 of the laws of 1995, are amended to read as follows:
   Notice to patient WITH THE USE OR PRESCRIPTION OF TOPICAL  THERAPEUTIC
 PHARMACEUTICAL  AGENTS  AND THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREAT-
 MENT OF GLAUCOMA AND OCULAR HYPERTENSION.
   (i) An optometrist prescribing TOPICAL steroids or  antiviral  medica-
 tion  shall inform each patient that in the event the condition does not
 improve within five days, a physician of the patient's  choice  will  be
 notified.
   §  11. Subdivision 10 of section 7101-a of the education law, as added
 by chapter 517 of the laws of 1995, is amended to read as follows:
   10. Pharmaceutical agents. Optometrists who  have  been  approved  and
 certified  by  the  department  shall  be permitted to use the following
 drugs:
   (a) Diagnostic pharmaceuticals.
   (b) Those optometrists having been certified for [phase  one]  TOPICAL
 therapeutic  pharmaceutical  agents  shall be authorized [(i) to use and
 recommend all nonprescription medications appropriate for ocular disease
 whether intended for topical or oral use; and (ii)] to use and prescribe
 all [phase one] TOPICAL therapeutic pharmaceutical agents  SPECIFIED  IN
 PARAGRAPH (E) OF SUBDIVISION ONE OF THIS SECTION, which are FDA approved
 and commercially available FOR TOPICAL USE.

 A. 1193--B                          6

   In the event an optometrist treats a patient with topical antiviral or
 steroidal  drugs  and the patient's condition either fails to improve or
 worsens within five days,  the  optometrist  shall  notify  a  physician
 designated by the patient or, if none, by the treating optometrist.
   (c) Those optometrists having been certified for [phase two] therapeu-
 tic pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR HYPERTEN-
 SION  shall  be  authorized to use and prescribe [phase two] therapeutic
 pharmaceutical agents FOR TREATMENT OF GLAUCOMA AND OCULAR  HYPERTENSION
 SPECIFIED IN PARAGRAPH (F) OF SUBDIVISION ONE OF THIS SECTION, which are
 FDA approved and commercially available.
   (D)  THOSE  OPTOMETRISTS  HAVING  BEEN  CERTIFIED FOR ORAL THERAPEUTIC
 PHARMACEUTICAL AGENTS SHALL BE AUTHORIZED  TO  USE  AND  PRESCRIBE  ORAL
 THERAPEUTIC PHARMACEUTICAL AGENTS SPECIFIED IN PARAGRAPH (G) OF SUBDIVI-
 SION ONE OF THIS SECTION, WHICH ARE FDA APPROVED AND COMMERCIALLY AVAIL-
 ABLE  AND  SHALL  COMPLY WITH ALL SAFETY INFORMATION AND SIDE-EFFECT AND
 WARNING ADVISORIES CONTAINED IN THE MOST CURRENT PHYSICIANS' DESK REFER-
 ENCE.
   (E) THOSE OPTOMETRISTS HAVING BEEN CERTIFIED FOR  TOPICAL  THERAPEUTIC
 PHARMACEUTICAL  AGENTS,  THERAPEUTIC PHARMACEUTICAL AGENTS FOR TREATMENT
 OF GLAUCOMA AND OCULAR HYPERTENSION OR 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.
   §  12.  Subdivision 8 of section 7104 of the education law, as amended
 by chapter 517 of the laws of 1995, is amended to read as follows:
   (8) Fees: pay a fee of two hundred twenty dollars  to  the  department
 for  admission  to a department conducted examination and for an initial
 license, a fee of one hundred fifteen dollars for each reexamination,  a
 fee  of  one  hundred  thirty-five  dollars  for  an initial license for
 persons not requiring admission to a department  conducted  examination,
 [and]  a  fee of two hundred ten dollars for each triennial registration
 period, [and] for additional authorization for the purpose of  utilizing
 diagnostic  pharmaceutical  agents,  a  fee  of  sixty  dollars, AND FOR
 CERTIFICATION  TO  USE  OR  PRESCRIBE  ORAL  THERAPEUTIC  PHARMACEUTICAL
 AGENTS, A FEE OF TWO HUNDRED FIFTY DOLLARS.
   §  13. This act shall take effect two years after it shall have become
 a law; provided that section nine of this act shall take effect  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.