S T A T E O F N E W Y O R K
________________________________________________________________________
1921
2021-2022 Regular Sessions
I N A S S E M B L Y
January 13, 2021
___________
Introduced by M. of A. PAULIN, COOK, CYMBROWITZ, ABINANTI, GUNTHER,
WEPRIN, HEVESI, STIRPE, DiPIETRO, BRABENEC, FAHY, COLTON, NORRIS,
BARRETT, PHEFFER AMATO, DINOWITZ, LALOR, ZEBROWSKI, STECK, HUNTER,
BRONSON, SOLAGES, PEOPLES-STOKES, DE LA ROSA, B. MILLER, MORINELLO,
FITZPATRICK, DICKENS, MAGNARELLI, PICHARDO, SANTABARBARA,
J. M. GIGLIO, D. ROSENTHAL, KIM, RODRIGUEZ, ABBATE, JONES, VANEL,
McDONOUGH, AUBRY, L. ROSENTHAL, ENGLEBRIGHT, LAVINE, JOYNER,
SEAWRIGHT, M. MILLER, FERNANDEZ, FALL, REILLY, REYES, SALKA, WALLACE,
JACOBSON, JEAN-PIERRE, MANKTELOW, TAYLOR, BENEDETTO, STERN, GRIFFIN,
BUTTENSCHON, EICHENSTEIN, LUPARDO, WOERNER -- Multi-Sponsored by -- M.
of A. BARCLAY, BLANKENBUSH, CAHILL, CARROLL, CUSICK, DAVILA, EPSTEIN,
FRIEND, GALEF, GOODELL, GOTTFRIED, HAWLEY, PALMESANO, PERRY, QUART,
J. RIVERA, TAGUE, THIELE, WALSH -- 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
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.
LBD02016-01-1
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(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
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
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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 TWENTY-TWO AND HAVE TAKEN AND SUCCESSFUL-
LY 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-
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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-THREE, 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-THREE, 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-
THREE UP TO THE FIRST REGISTRATION DATE THEREAFTER. AN OPTOMETRIST WHO
HAS NOT SATISFIED THE MANDATORY CONTINUING EDUCATION REQUIREMENT PURSU-
ANT TO THIS SUBDIVISION SHALL NOT BE ISSUED A TRIENNIAL REGISTRATION
CERTIFICATE BY THE DEPARTMENT AND SHALL NOT PRACTICE UNLESS AND UNTIL A
CONDITIONAL 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
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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.
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-
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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, 2023. 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 to be made and completed on or
before such effective date.